EP3171786B1 - Vorrichtungen zur behandlung von herzinsuffizienz - Google Patents
Vorrichtungen zur behandlung von herzinsuffizienz Download PDFInfo
- Publication number
- EP3171786B1 EP3171786B1 EP15824456.6A EP15824456A EP3171786B1 EP 3171786 B1 EP3171786 B1 EP 3171786B1 EP 15824456 A EP15824456 A EP 15824456A EP 3171786 B1 EP3171786 B1 EP 3171786B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- proximal
- retention
- distal
- region
- retrieval
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
- 206010019280 Heart failures Diseases 0.000 title description 14
- 230000014759 maintenance of location Effects 0.000 claims description 366
- 210000003157 atrial septum Anatomy 0.000 claims description 57
- 230000001746 atrial effect Effects 0.000 claims description 16
- 230000007704 transition Effects 0.000 description 85
- 210000001519 tissue Anatomy 0.000 description 39
- 239000000463 material Substances 0.000 description 30
- 238000005452 bending Methods 0.000 description 25
- 210000005246 left atrium Anatomy 0.000 description 18
- 206010007559 Cardiac failure congestive Diseases 0.000 description 15
- 239000008280 blood Substances 0.000 description 15
- 230000007246 mechanism Effects 0.000 description 15
- 238000000034 method Methods 0.000 description 15
- 210000004369 blood Anatomy 0.000 description 14
- 230000000670 limiting effect Effects 0.000 description 13
- 210000005245 right atrium Anatomy 0.000 description 13
- 238000011282 treatment Methods 0.000 description 11
- 230000001105 regulatory effect Effects 0.000 description 10
- 238000001727 in vivo Methods 0.000 description 9
- 238000013461 design Methods 0.000 description 8
- 229920000295 expanded polytetrafluoroethylene Polymers 0.000 description 8
- 208000003037 Diastolic Heart Failure Diseases 0.000 description 7
- 239000003550 marker Substances 0.000 description 7
- 230000008569 process Effects 0.000 description 7
- -1 UHMPE Polymers 0.000 description 6
- 230000004888 barrier function Effects 0.000 description 6
- 229920000642 polymer Polymers 0.000 description 6
- 208000008253 Systolic Heart Failure Diseases 0.000 description 5
- 210000002837 heart atrium Anatomy 0.000 description 5
- 210000005240 left ventricle Anatomy 0.000 description 5
- 230000008901 benefit Effects 0.000 description 4
- 230000035876 healing Effects 0.000 description 4
- 229910052751 metal Inorganic materials 0.000 description 4
- 239000002184 metal Substances 0.000 description 4
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 4
- 239000004810 polytetrafluoroethylene Substances 0.000 description 4
- 208000035478 Interatrial communication Diseases 0.000 description 3
- 208000008883 Patent Foramen Ovale Diseases 0.000 description 3
- 208000007536 Thrombosis Diseases 0.000 description 3
- 229910045601 alloy Inorganic materials 0.000 description 3
- 239000000956 alloy Substances 0.000 description 3
- 238000004873 anchoring Methods 0.000 description 3
- 208000013914 atrial heart septal defect Diseases 0.000 description 3
- 206010003664 atrial septal defect Diseases 0.000 description 3
- 210000005242 cardiac chamber Anatomy 0.000 description 3
- 230000000747 cardiac effect Effects 0.000 description 3
- 210000004027 cell Anatomy 0.000 description 3
- 239000013013 elastic material Substances 0.000 description 3
- 230000003628 erosive effect Effects 0.000 description 3
- 230000006870 function Effects 0.000 description 3
- 239000007943 implant Substances 0.000 description 3
- 208000014674 injury Diseases 0.000 description 3
- 238000005304 joining Methods 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 230000035515 penetration Effects 0.000 description 3
- 238000011458 pharmacological treatment Methods 0.000 description 3
- 239000011148 porous material Substances 0.000 description 3
- 238000011084 recovery Methods 0.000 description 3
- 230000002829 reductive effect Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 230000008467 tissue growth Effects 0.000 description 3
- 230000008733 trauma Effects 0.000 description 3
- 102000010834 Extracellular Matrix Proteins Human genes 0.000 description 2
- 108010037362 Extracellular Matrix Proteins Proteins 0.000 description 2
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 2
- 239000004372 Polyvinyl alcohol Substances 0.000 description 2
- 239000004699 Ultra-high molecular weight polyethylene Substances 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 230000017531 blood circulation Effects 0.000 description 2
- 230000004663 cell proliferation Effects 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 210000002744 extracellular matrix Anatomy 0.000 description 2
- 239000000835 fiber Substances 0.000 description 2
- 238000003384 imaging method Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 229910001000 nickel titanium Inorganic materials 0.000 description 2
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 2
- BASFCYQUMIYNBI-UHFFFAOYSA-N platinum Chemical compound [Pt] BASFCYQUMIYNBI-UHFFFAOYSA-N 0.000 description 2
- 229920001155 polypropylene Polymers 0.000 description 2
- 239000004814 polyurethane Substances 0.000 description 2
- 229920002635 polyurethane Polymers 0.000 description 2
- 229920002451 polyvinyl alcohol Polymers 0.000 description 2
- 238000005086 pumping Methods 0.000 description 2
- 230000004044 response Effects 0.000 description 2
- 229910052715 tantalum Inorganic materials 0.000 description 2
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 description 2
- 229920000785 ultra high molecular weight polyethylene Polymers 0.000 description 2
- 208000004434 Calcinosis Diseases 0.000 description 1
- 208000031229 Cardiomyopathies Diseases 0.000 description 1
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- JPVYNHNXODAKFH-UHFFFAOYSA-N Cu2+ Chemical compound [Cu+2] JPVYNHNXODAKFH-UHFFFAOYSA-N 0.000 description 1
- 229910052692 Dysprosium Inorganic materials 0.000 description 1
- 229910052691 Erbium Inorganic materials 0.000 description 1
- CWYNVVGOOAEACU-UHFFFAOYSA-N Fe2+ Chemical compound [Fe+2] CWYNVVGOOAEACU-UHFFFAOYSA-N 0.000 description 1
- 229910052688 Gadolinium Inorganic materials 0.000 description 1
- WAEMQWOKJMHJLA-UHFFFAOYSA-N Manganese(2+) Chemical compound [Mn+2] WAEMQWOKJMHJLA-UHFFFAOYSA-N 0.000 description 1
- 208000009525 Myocarditis Diseases 0.000 description 1
- VEQPNABPJHWNSG-UHFFFAOYSA-N Nickel(2+) Chemical compound [Ni+2] VEQPNABPJHWNSG-UHFFFAOYSA-N 0.000 description 1
- 229920000954 Polyglycolide Polymers 0.000 description 1
- 239000004642 Polyimide Substances 0.000 description 1
- 206010037423 Pulmonary oedema Diseases 0.000 description 1
- 229910001347 Stellite Inorganic materials 0.000 description 1
- 229910052771 Terbium Inorganic materials 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 229920010741 Ultra High Molecular Weight Polyethylene (UHMWPE) Polymers 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 229910052769 Ytterbium Inorganic materials 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 150000001412 amines Chemical class 0.000 description 1
- 206010002022 amyloidosis Diseases 0.000 description 1
- 239000003146 anticoagulant agent Substances 0.000 description 1
- 229940127219 anticoagulant drug Drugs 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000036772 blood pressure Effects 0.000 description 1
- 230000002308 calcification Effects 0.000 description 1
- 230000001964 calcium overload Effects 0.000 description 1
- 230000001269 cardiogenic effect Effects 0.000 description 1
- 230000010261 cell growth Effects 0.000 description 1
- BFGKITSFLPAWGI-UHFFFAOYSA-N chromium(3+) Chemical compound [Cr+3] BFGKITSFLPAWGI-UHFFFAOYSA-N 0.000 description 1
- AHICWQREWHDHHF-UHFFFAOYSA-N chromium;cobalt;iron;manganese;methane;molybdenum;nickel;silicon;tungsten Chemical compound C.[Si].[Cr].[Mn].[Fe].[Co].[Ni].[Mo].[W] AHICWQREWHDHHF-UHFFFAOYSA-N 0.000 description 1
- 230000001684 chronic effect Effects 0.000 description 1
- XLJKHNWPARRRJB-UHFFFAOYSA-N cobalt(2+) Chemical compound [Co+2] XLJKHNWPARRRJB-UHFFFAOYSA-N 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 210000003748 coronary sinus Anatomy 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000008021 deposition Effects 0.000 description 1
- 230000035487 diastolic blood pressure Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 239000002934 diuretic Substances 0.000 description 1
- 229940030606 diuretics Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- KBQHZAAAGSGFKK-UHFFFAOYSA-N dysprosium atom Chemical compound [Dy] KBQHZAAAGSGFKK-UHFFFAOYSA-N 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229910000701 elgiloys (Co-Cr-Ni Alloy) Inorganic materials 0.000 description 1
- 230000010102 embolization Effects 0.000 description 1
- 238000005538 encapsulation Methods 0.000 description 1
- UYAHIZSMUZPPFV-UHFFFAOYSA-N erbium Chemical compound [Er] UYAHIZSMUZPPFV-UHFFFAOYSA-N 0.000 description 1
- 125000000816 ethylene group Chemical group [H]C([H])([*:1])C([H])([H])[*:2] 0.000 description 1
- 239000003527 fibrinolytic agent Substances 0.000 description 1
- 229920002313 fluoropolymer Polymers 0.000 description 1
- UIWYJDYFSGRHKR-UHFFFAOYSA-N gadolinium atom Chemical compound [Gd] UIWYJDYFSGRHKR-UHFFFAOYSA-N 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 239000003102 growth factor Substances 0.000 description 1
- 229910000856 hastalloy Inorganic materials 0.000 description 1
- 230000000004 hemodynamic effect Effects 0.000 description 1
- 229920001903 high density polyethylene Polymers 0.000 description 1
- 239000004700 high-density polyethylene Substances 0.000 description 1
- SCKNFLZJSOHWIV-UHFFFAOYSA-N holmium(3+) Chemical compound [Ho+3] SCKNFLZJSOHWIV-UHFFFAOYSA-N 0.000 description 1
- 239000000017 hydrogel Substances 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 229910052742 iron Inorganic materials 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 230000000302 ischemic effect Effects 0.000 description 1
- 238000003698 laser cutting Methods 0.000 description 1
- 230000005291 magnetic effect Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 229910001092 metal group alloy Inorganic materials 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 208000010125 myocardial infarction Diseases 0.000 description 1
- 208000031225 myocardial ischemia Diseases 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 210000001087 myotubule Anatomy 0.000 description 1
- QEFYFXOXNSNQGX-UHFFFAOYSA-N neodymium atom Chemical compound [Nd] QEFYFXOXNSNQGX-UHFFFAOYSA-N 0.000 description 1
- 239000004745 nonwoven fabric Substances 0.000 description 1
- 238000012856 packing Methods 0.000 description 1
- 239000002907 paramagnetic material Substances 0.000 description 1
- 230000036961 partial effect Effects 0.000 description 1
- 230000001991 pathophysiological effect Effects 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 229910052697 platinum Inorganic materials 0.000 description 1
- 229920002492 poly(sulfone) Polymers 0.000 description 1
- 229920001610 polycaprolactone Polymers 0.000 description 1
- 239000004632 polycaprolactone Substances 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 239000004633 polyglycolic acid Substances 0.000 description 1
- 229920001721 polyimide Polymers 0.000 description 1
- 229920000098 polyolefin Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 230000036316 preload Effects 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 208000005333 pulmonary edema Diseases 0.000 description 1
- 210000003492 pulmonary vein Anatomy 0.000 description 1
- 238000007634 remodeling Methods 0.000 description 1
- 239000012858 resilient material Substances 0.000 description 1
- 210000005241 right ventricle Anatomy 0.000 description 1
- DOSGOCSVHPUUIA-UHFFFAOYSA-N samarium(3+) Chemical compound [Sm+3] DOSGOCSVHPUUIA-UHFFFAOYSA-N 0.000 description 1
- 229910001285 shape-memory alloy Inorganic materials 0.000 description 1
- 230000007480 spreading Effects 0.000 description 1
- 238000003892 spreading Methods 0.000 description 1
- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 230000004083 survival effect Effects 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- GZCRRIHWUXGPOV-UHFFFAOYSA-N terbium atom Chemical compound [Tb] GZCRRIHWUXGPOV-UHFFFAOYSA-N 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 description 1
- 229910052721 tungsten Inorganic materials 0.000 description 1
- 239000010937 tungsten Substances 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 238000011144 upstream manufacturing Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
- 201000003130 ventricular septal defect Diseases 0.000 description 1
- 230000003313 weakening effect Effects 0.000 description 1
- NAWDYIZEMPQZHO-UHFFFAOYSA-N ytterbium Chemical compound [Yb] NAWDYIZEMPQZHO-UHFFFAOYSA-N 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
- A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
- A61B2017/00252—Making holes in the wall of the heart, e.g. laser Myocardial revascularization for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00592—Elastic or resilient implements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00601—Implements entirely comprised between the two sides of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00623—Introducing or retrieving devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3966—Radiopaque markers visible in an X-ray image
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
- A61F2002/0072—Delivery tools therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2002/249—Device completely embedded in the heart wall
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/04—General characteristics of the apparatus implanted
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/12—Blood circulatory system
- A61M2210/125—Heart
Definitions
- the present teachings relate to devices for treating heart failures.
- An aspect of the present teachings relates to a device that can be used to change (e.g., reduce) the blood pressure in a heart chamber, for example, by creating a shunt, and optionally regulating the flow of blood through the shunt in order to enhance the therapeutic effect of the shunt. It is also disclosed a method of utilizing such a device, for example, in treating congestive heart failure and its related conditions, for example, acute cardiogenic pulmonary edema caused by an elevated pressure in a left side chamber in the heart.
- CHF Congestive heart failure
- myocardial ischemia due to, e.g., myocardial infarction
- cardiomyopathy e.g., myocarditis, amyloidosis
- CHF causes a reduced cardiac output and inadequate blood to meet the needs of body tissues.
- Treatments for CHF include: (1) pharmacological treatments, (2) assisting systems, and (3) surgical treatments.
- Pharmacological treatments e.g., with diuretics, are used to reduce the workload of a heart by reducing blood volume and preload. While pharmacological treatments can improve quality of life, they have little effect on survival.
- Assisting devices e.g., mechanical pumps, are used to reduce the load on a heart by performing all or part of the pumping function normally done by the heart. However, in a chronic ischemic heart, high-rate pacing may lead to an increased diastolic pressure, calcium overload, and damages to the muscle fibers.
- There are at least three surgical procedures for treating a heart failure (1) heart transplant, (2) dynamic cardiomyoplasty, and (3) the Batista partial left ventriculectomy. These surgical treatments are invasive and have many limitations.
- CHF is generally classified into systolic heart failure (SHF) or diastolic heart failure (DHF).
- SHF the pumping action of a heart is reduced or weakened.
- a normal ejection fraction (EF) the volume of blood ejected out of the left ventricle (stroke volume) divided by the maximum volume remaining in the left ventricle at the end of the diastole or relaxation phase, is greater than 50%.
- EF normal ejection fraction
- stroke volume the volume of blood ejected out of the left ventricle
- EF is decreased to less than 50%.
- a patient with SHF may have an enlarged left ventricle because of cardiac remodeling developed to maintain an adequate stroke-volume. This pathophysiological phenomenon is often associated with an increased atrial pressure and an increased left ventricular filling pressure.
- DHF is a heart failure without any major valve disease even though the systolic function of the left ventricle is preserved. Generally, DHF is a failure of the ventricle to adequately relax and expand, resulting in a decrease in the stroke volume of the heart. Presently, there are very few treatment options for patients suffering from DHF. DHF afflicts between 30% and 70% of patients with CHF.
- US 8,740,962 and US 8,460,372 both describe prostheses that may be implanted in an opening in the septal wall of the heart to provide a shunt or channel permitting blood to flow from the left atrium into the right atrium.
- These devices collapse to a smaller configuration for delivery to the heart via a catheter and expand to a larger configuration (e.g., through self-expansion) upon deployment across an opening in the septal wall.
- Some of these devices have central cores with sufficient radial strength to maintain the patency of the septal wall opening and flexible anchors on both sides of the central core to contact the septal wall for atraumatic anchoring of the device.
- Some of these devices have retrieval legs and other features providing attachment points for delivery and/or retrieval for possible removal or redeployment.
- US2012/0265296 discloses a system for treating a heart condition in a patient comprising a body element comprising a cylindrical core segment defining a passage, a first annular flange adapted to engage a first surface of an atrial septum of the patient, and a second annular flange adapted to engage a second surface of the atrial septum of the patient.
- the clinician may be desirable for the clinician to be able to observe the deployed configuration of elements of the device within the heart, such as the anchoring or retention features, prior to releasing the device from the delivery system.
- the portions of the prosthesis that attach to the delivery system may move out of the blood flow path through the prosthesis.
- the prosthesis attachment elements may be movable back toward the center of the prosthesis so that the prosthesis can be collapsed and drawn into the retrieval catheter.
- the delivery catheter may need to approach the implantation site along an acute angle with respect to the septal wall, it may be desirable for the implant attachment features to be flexible enough to permit the implant to bend away from the longitudinal axis of the catheter during deployment of the implant into the septal wall. Finally, it may be useful for any retrieval features on the device to operate in combination with a strong central core and flexible anchors or retention segments.
- the invention provides a device for implanting into an atrial septum of a patient, the device having a core region with a plurality of core segments surrounding a central opening, the core region being adapted and configured to be disposed in an opening in the atrial septum; a distal retention region with a plurality of distal retention segments extending from the core segments, the distal retention segments being adapted to engage tissue on a left atrial side of the septal wall; a proximal retention region having a plurality of proximal retention segments extending from the core segments, the proximal retention segments being adapted to engage tissue on a right atrial side of the septal wall; and a retrieval region with a plurality (e.g., two or four) of retrieval members extending from the proximal retention segments, each retrieval member having a connector at a proximal end, the connector being adapted to connect to a delivery system.
- a plurality e.g., two or four
- the connectors are disposed more radially inward in the delivery configuration than in the deployed configuration.
- the connectors may be, e.g., eyelets.
- the connectors may extend radially inward from an end of the retrieval members in the deployed configuration. In some embodiments, the connectors may extend distally from an end of the retrieval members in the deployed configuration.
- the device also has a retrieval configuration in which the connectors are disposed radially inward from deployed configuration positions and the proximal and distal retention segments are each in substantially same positions as in the deployed configuration.
- the retrieval members may extend further proximally from the proximal retention region in the delivery configuration than in the retrieval configuration.
- the device can be used to regulate the pressure in a heart chamber.
- the device can be used to (a) change an elevated chamber pressure and (b) prevent embolization from the right to left atria in a patient who suffers from CHF or has a Patent Foramen Ovale (PFO) or an Atrial Septal Defect (ASD) but needs a residual flow between the atria so as not to traumatize the heart hemodynamics.
- PFO Patent Foramen Ovale
- ASD Atrial Septal Defect
- distal and proximal refer portion of the device, they mostly refer to a device in its elongated deliver configuration.
- proximal shall mean close to the operator (less into the body) and “distal” shall mean remote from the operator (further into the body). In positioning a medical device from a downstream access point, “distal” is more upstream and “proximal” is more downstream.
- aperture refers to any anatomical anomalies such as PFO, ASD, VSD, or an anatomical feature (such as an opening in the septal wall) created for the purpose of creating a shunt.
- substantially means plus or minus 10%.
- a medical device includes an open central core region and two retention regions.
- the medical device is positioned through an aperture in a septum, creating a shunt, for example, between the left and right atria.
- the two retention regions of the medical device are disposed on the opposite sides of the septum.
- a medical device according to the present teachings is extended into an elongated profile for a percutaneous delivery and resumes a preset profile in vivo after deployment.
- An embodiment of the device in the present teaching has a distal retention portion configured to be positioned against the left atrial side of the septum, a proximal retention portion configured to be positioned against the right atrial side of the septum, and a central core portion disposed between the distal and proximal retention portions and configured to create a conduit for blood to flow through.
- An embodiment of the device in the present teaching has an elongated configuration for delivering through a catheter system and an expanded configuration securing the device across the septum.
- the device is configured to transition from a delivery configuration to a deployed configuration through self-expansion or mechanical actuations.
- both the distal and proximal retention portions of the device are delivered in radially contracted configurations and expand radially while the device contracts longitudinally.
- the central core portion is delivered in a radially contracted configuration and expands radially during deployment.
- one or both of the distal and proximal retention portions of the device contract longitudinally.
- one of or both of the deployed distal and proximal retention portions has a generally flange-like profile.
- the generally flange-like profile is made of a multiple segments or elements extending in a generally radial configuration from the central core portion.
- the deployed distal retention portion is configured to be positioned against one side of the atrial septum. In some embodiments, the deployed proximal retention portion is configured to be positioned against one side of the atrial septum. In certain embodiments, both the deployed distal retention portion and the deployed proximal retention portion are configured to be positioned against both sides of the atrial septum. According to some embodiments, both the deployed distal and proximal retention portions apply a compression force against the septum from both sides, thereby securing the device across the septum.
- Figures 1-6 show an embodiment of a pressure regulating device 10 according to this invention.
- Figures 1 and 2 show the device 10 in a deployed configuration.
- Figure 3 shows device 10 in a delivery configuration.
- a distal retention region 12 extends distally from a central core region 16 via a distal transition region 14, and a proximal retention region 20 extends proximally from core region 16 via a proximal transition region 18.
- device 10 (including distal retention region 12, central core region 16 and proximal retention region 20) is radially compressed and axially elongated compared to the deployed configuration shown in Figures 1 and 2 .
- Device 10 may be delivered via a delivery catheter (not shown) for deployment in the atrial septum of the patient's heart.
- the central core region 16 includes an opening 24 to permit blood to flow through the device from the left atrium to the right atrium.
- the radially expanded proximal retention region 20 has a plurality of flexible retention segments 60 that atraumatically engage the septal wall in the right atrium
- the radially expanded distal retention region 12 has a plurality of flexible retention segments 46 that atraumatically engage the septal wall in the left atrium.
- the proximal and distal retention regions may cooperate to apply a compressive force to the septal wall.
- the proximal and distal retention regions do not apply a compressive force to the septal wall.
- the core region may also apply a radially outward force on the portion of the septal wall through which it extends. In other embodiments, the core region does not apply a radially outward force on the portion of the septal wall through which it extends.
- the radial span of the distal retention region 12 in the deployed configuration may be the same as the radial span of the proximal retention region 20. In other embodiments, the radial span of the distal retention region 12 may be greater than the radial span of the proximal retention region to, e.g., account for the typically greater pressure in the left atrium compared to the pressure in the right atrium.
- the distal retention region has a general diameter of 8-20 mm upon deployment. In another embodiment, the deployed proximal retention region has a general diameter of 8-20 mm upon deployment. According to some embodiments, upon deployment, the diameter of the deployed core region of the device is about 25-50% of the overall diameter of the deployed distal retention region.
- the retrieval region 22 includes retrieval legs 74 extending proximally and radially inwardly from the radially outward ends of the proximal retention segments 60, optionally via intermediate legs 76 disposed between the retrieval leg 74 and the proximal retention segments 60.
- each secondary retrieval leg 76 extends proximally from the proximal end 64 of a proximal retention segment 60.
- a distal end 78 of a secondary retrieval leg 76 joins the proximal end 64 of a proximal retention segment 60 where two adjacent proximal retention struts 66 join.
- Loops or eyelets 72 at the proximal ends of the retrieval legs 74 serve as connectors for the delivery and/or retrieval system. As shown in Figures 1 and 2 , in the device's deployment configuration the eyelets 72 are proximal to and radially outward from the outer boundary of opening 24 and therefore out of the path of any blood flowing through opening 24. In this embodiment, eyelets 72 are oriented in a plane generally perpendicular to the longitudinal axis of the core region 16.
- Figure 3 is a perspective view of device 10 in its collapsed delivery configuration. As shown, the radial dimensions of the proximal retention region 20, central core region 16 and distal retention region 12 are less in the delivery configuration than in the deployed configuration shown in Figures 1 and 2 .
- the retrieval leg 74 and eyelets 72 extend proximally from the proximal retention region and connect to a delivery or retrieval system (not shown).
- a delivery system advances device 10 through and out of a catheter.
- the distal retention region 14 of device 10 begins to self-expand in the left atrium.
- the core region 16 and proximal retention region 20 expand as they emerge from the catheter in the septal wall opening and right atrium, respectively, all while the eyelets 72 of the retrieval legs 74 are still connected to the delivery system.
- distal retention segments 46, core region 16 and proximal retention segments 60 are substantially in their deployed configurations even while retrieval legs 74 extend proximally into the delivery catheter (not shown).
- retrieval legs 74 have emerged from the delivery catheter and have begun moving toward their expanded at-rest shapes; eyelets 72 are radially inward from their at-rest positions because they are still connected to the delivery system. This position is the retrieval configuration of the device 10. After release from the delivery system, retrieval legs 74 and eyelets 72 move radially outward to their at-rest positions radially outside of the devices opening 24 (i.e., the deployed configuration shown in Figure 1 ).
- the retrieval device grasps eyelets 72, moving them radially inward to the retrieval configuration. Device 10 is then pulled proximally into the retrieval catheter.
- Figure 6 is a two-dimensional view of a portion of the structure of a portion of device 10 in its elongated delivery configuration and in flattened format solely for the purpose of showing various components of the device.
- the central core region 16 of the device 10 is formed of a continuous strut 26 in a wavy profile with hairpin turns at each end of the core region 16.
- the strut 26 extends longitudinally from a first end 28 of the core region 16 toward the second end 30.
- the strut Upon reaching a second end of the core region 16, the strut makes a "U" turn, then extends longitudinally back to the first send 28.
- the strut 26 Upon reaching the first end 28 of the core region 16, the strut 26 makes another "U” turn and extends longitudinally and distally toward the second end 30 of the core region 16. This wavy pattern repeats and continues throughout the tubular surface of the core region 16. The ends of the strut 26 join the beginning of the strut 26 to form a closed loop. According to some embodiments, a gap 32 exists between two adjacent portions of the strut 26. According to some embodiments, the profile, including but not limited to shape, width and thickness of the strut 26 may vary at in some locations, either for the purposes of ease of manufacturing or reduced stress concentration after implantation.
- the gap 32 in the delivery configuration is small such that the adjacent portions of the strut 26 are packed tightly close to one another and that the gap 32 in the deployed configuration is enlarged such that the adjacent portions of the strut 26 have moved away from one another so that the core region 16 assumes a larger profile.
- Core region 16 with a wave strut pattern can be fabricated by cutting a tube by laser or another method known to those skilled in the art.
- the core region could adopt either open-cell or closed-cell designs of any patterns known to those skilled in the art.
- the diameter of the core region increases and the core region reduces in length, sometimes slightly.
- the overall length of the core region remains the same.
- the device 10 in its delivery configuration is configured to be delivered and deployed through a 5 French - 12 French catheter.
- the elongated device 10 has a diameter ranging from about 1 mm to about 4 mm
- the central core region 16 in a deployed configuration has a diameter ranging from about 3 mm to about 12 mm, or from about 100% to about 300% of that of the core region 16 in its delivery configuration.
- the strut 26 of the shunt portion 16 has a width of about 0.005 inch to about 0.030 inch (0.013cm to about 0.076cm).
- the gap 32 between two adjacent portions of the strut 26 is from about 0" to about 0.010"" (about 0cm to about 0.025cm), and upon deployment, the gap 32 between two adjacent portions of the strut 26 is up to about 0.075" (0.191cm).
- the device 10 in its delivery configuration has an overall length of about 5-25 mm, with the length of the core region 16 being 0.5-5mm.
- the length of the core region 16 ranges from about 1 mm to about 7 mm, with the overall length of the device 10 ranging from about 3mm to about 12mm.
- the length of the core region 16 of a deployed device ranges from about 30 to about 70% of the length of the device in the deployed profile.
- the distal end 28 of the core region 16 of the device 10 extends from a distal transition portion 14.
- the distal transition portion 14 includes a plurality of distal transition struts 34 each extending from the distal ends 28 of the core region 16 and terminating at the proximal ends 42 of the distal retention segment 46 of the device 10.
- a proximal end 38 of each distal transition strut 34 joins the core region 16 at the distal end 28 of each hairpin turn
- a distal end 36 of each distal transition struts 34 joins the distal retention segments 46 as shown in Figure 6 .
- the distal transition portion 14 When the device 10 is at its delivery configuration, such as illustrated in Figure 3 , the distal transition portion 14 has a small generally tubular profile with adjacent struts 34 packed closely and parallel to one another. The distal transition portion 14 is also configured to transform from a delivery configuration to a deployed configuration. During such a transition, a distal section of the struts 34 extends radially outwardly, and a proximal section of the struts 34 expands, as the core region 16 expands radially into its deployed profile.
- the distal transition struts 34 bend at a location so that the core region 16 of the device 10 has a tubular profile at or near the proximal end 28 of the distal transition struts 34, and at least a part of the distal retention region 12 of the device 10 has a radially outwardly relatively disc-like profile that is at an angle, sometimes perpendicular, to the longitudinal axis of the core region 16 at the distal end 30 of the distal transition struts 34.
- the bending location on the distal transition struts 34 has a narrower width ("waist") than another portion, sometimes the remaining portions, of the struts 34.
- the lead-ins from both directions generally have a curved configuration.
- the bending location has curved lead-ins from both ends, other geometries, shapes, or profiles for narrowing the strut width at the bending location could also be used.
- what has been disclosed should not be viewed as limiting to the scope of the present teaching.
- the waist has a width from about 0.003" to about 0.015" (about 0.008cm to about 0.038cm), or from about 30% to about 100% of the width of the widest portion of the distal transition struts 34. Additionally, in order to control the bending direction, the width of the distal transition struts 34 can be greater than the thickness. Additionally, the length of the distal transition portion, as well as the width of the waist could vary according to the overall size of the device and design criteria.
- the device 10 includes a distal retention region 12.
- the distal retention region 12 of the device 10 has an expanded disc-like profile when the device is deployed, as illustrated in Figure 1 , and a collapsed generally tubular profile during delivery, as illustrated in Figure 3 .
- the distal retention region 12 includes multiple retention segments 46 each including or formed by two adjacent distal retention struts 40. As shown, two separate struts 40 extend distally from the distal ends 36 of distal transition struts 34. The proximal ends 42 of the two distal retention struts 40 are side by side from each other, with a gap 48 in between.
- the distal ends 44 of two distal retention struts 40 extend from the distal end 36 of two adjacent distal transition struts 34 connected to each other, forming a distal retention segment 46.
- the distal retention segment 46 formed by two adjacent distal retention struts 44 in delivery configuration, is relatively elongated with two adjacent distal retention struts 44 extending close to each other, and in the deployed configuration, the distal retention segment 46 formed by two adjacent distal retention struts 44 is expanded in width with the proximal ends 42 of the two distal retention struts 40 spreading apart and shortened in overall length, with the gap 48 between the two adjacent distal retention struts 44 widening.
- the distal retention region 12 radially collapses with each distal retention segment 46 orienting longitudinally along the longitudinal axis of the core region 16.
- the distal retention segments 46 expand radially with each distal retention segment 46 forming a plane at an angle, for example, perpendicular, to the longitudinal axis of the core region 16.
- the distal retention region 12 is configured to be deployed inside the left atrium with each of the distal retention segments 46 located at the left atrial side of the atrial septum. In certain embodiments, the distal retention opposes the left atrial side of the atrial septum.
- the distal retention region 12 upon deployment, forms a disc-like configuration, with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 46 contacting the atrial septum.
- the distal retention region 12 forms an umbrella-like configuration with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 46 doming away from the atrial septum.
- one or more distal ends of the distal retention segments 46 can contact the atrial septum.
- the distal retention region 12 forms a generally straight slope profile with at least a portion, sometimes a substantial portion, of the surface area of each distal retention segment 46 not contacting the atrial septum.
- one or more distal ends of the distal retention segments 46 remain furthest away from the atrial septum.
- One skilled in the art should understand that other suitable profile could also be used.
- the exemplary embodiments discussed, shown, or mentioned herein should not be viewed as limiting.
- the distal ends 50 of each distal retention segment 46 includes a foot 52, as illustrated in Figure 6 .
- the foot 52 is configured to prevent the distal ends 50 of the distal retention segments 46 from penetrating, piercing, or eroding into the septal tissues.
- the foot 52 is configured to provide a larger surface area for contacting the tissues and/or reducing the force that the distal retention segments 46 apply onto the tissues.
- the foot 52 is also configured to incorporate a radiopaque marker. For example, as illustrated in Figure 6 , a radiopaque marker can be wedged into a hole on each of the feet 52.
- the device 10 includes a proximal transition portion 18. Similar to the distal transition portion 14, the proximal transition portion 18 includes a plurality of proximal transition struts 54 each extending from the proximal end 30 of the core region 16 and terminating at the distal end 62 of the proximal transition strut 66 of the device 10. As illustrated in Figure 6 , a distal end 56 of each proximal transition strut 54 joins the core region 16 at the proximal end 30 of each hairpin turn and joins the proximal retention segments 60 at the distal end 62 of the proximal transition strut 66.
- the proximal transition portion 18 When the device 10 is at its delivery configuration, the proximal transition portion 18 has a small generally tubular profile, such as illustrated in Figure 3 , with adjacent struts 54 packing closely and parallel to each other.
- the proximal transition portion 18 is also configured to transform from a delivery configuration to a deployed configuration. During such transition, a proximal section of the struts 54 extends radially outwardly, and a distal section of the struts 54 expands as the core region 16 expands radially into its deployed configuration.
- the proximal transition struts 54 bend at a location so that the core region 16 of the device has a tubular profile at the distal end 56 of the proximal transition struts 54, and the proximal retention region 20 of the device 10 have a radially outward umbrella-shaped profile that is generally at an angle, sometimes perpendicular, to the longitudinal axis of the core region 16 at the proximal end 58 of the proximal transition struts 54.
- the bending location on the proximal transition struts 54 has a narrower width ("waist") than another portion, sometimes the remaining portions, of the struts 54.
- the lead-ins from both directions have a generally curved configuration.
- the bending location has a generally curved lead-ins from both ends of the waist, other geometries, shapes, or profiles for narrowing the strut width at the bending location could also be used. Thus what has been disclosed should not be viewed as limiting.
- the waist has a width from about 0.006" to about 0.030" (about 0.015cm to about 0.076cm), or from about 25 to about 80% of the width of the widest portion of the proximal transition struts 54.
- the width of the proximal transition struts 54 can be greater than the thickness of the proximal transition struts.
- the proximal transition struts 54 are shorter and narrower than the distal transition struts 34 of the device.
- the proximal transition struts 54 can have the same length and/or width as the distal transition struts 34.
- the device 10 can also have a proximal retention region 20.
- the proximal retention region 20 of the device 10 has an expanded umbrella-like profile when deployed, as illustrated in Figure 1 , and a collapsed generally tubular profile during delivery, as illustrated in Figure 3 .
- the proximal retention region 20 includes multiple proximal retention segments 60.
- each of the proximal retention segments is formed by two adjacent proximal retention struts 66. As shown in the figure, two separate struts 66 extend proximally from the proximal end 58 of a proximal transition strut 54.
- the distal ends 62 of the two proximal retention struts 66 are located side by side from each other with a gap 70 in between. According to one embodiment, the distal ends 62 of two proximal retention struts 66 extended from the proximal end 58 of two adjacent proximal transition struts 54 connects to each other, forming a proximal retention segment 60.
- the proximal retention segment 60 formed by two adjacent proximal retention struts 66 are relatively elongated with two adjacent proximal retention struts 66 extending close to each other; and in deployed configuration, the proximal retention segment 60 formed by two adjacent proximal retention struts 66 are expanded in width and shortened in the overall length with the gap 70 between two adjacent proximal retention struts 66 widened.
- the proximal retention portion 20 when the device 10 is in its delivery configuration, the proximal retention portion 20 radially collapses with the proximal retention segments 60 orienting longitudinally along the longitudinal axis of the core region 16, and when the device 10 is in its deployed configuration, the proximal retention portion 20 radially expands with the proximal retention segment 60 curving distally, for example as illustrated in Figure 1 .
- a first section of each proximal retention segment 60 curves distally toward the atrial septum forming a first curve
- a second section of each proximal retention segment 60 curves proximally away from the atrial septum forming a second curve, with a portion of each proximal retention segment 60 between the first and second sections of each proximal retention segment 60 contacting the septal tissue.
- the curved deployment configuration of the proximal retention region 20 allows the device to accommodate various atrial septum thickness.
- the curved proximal retention segments 60 can fully assume its pre-defined curved deployment configuration.
- the curved proximal retention segments 60 can oppose the atrial septum, and when the septum pushes back, the curved proximal retention segments 60 can deflect at their first curve while maintaining the device 10 in place.
- curving the second section of the deployed proximal retention region 20 away from the atrial septum enlarges the contacting surface area with the septal tissue, thereby preventing any trauma to the tissue.
- the second curve of the proximal retention segments 60 can start at any location near or at the proximal ends 64 of each retention segment 60.
- the proximal retention region struts 66 in a delivery configuration, have a similar width as the distal retention struts 40. In other embodiments, the proximal retention struts 66 have a different width than the distal retention struts 40. In yet another embodiment, the width of the strut 26 of the core region 16 is greater than that of the proximal retention struts 66 and that of the distal retention struts 40, so that the core region 16 is more rigid than the proximal and distal retention portions 12, 20.
- the stiff core region 16 pushes the surrounding tissue radially outwardly, thereby maintaining the size of the opening for the treatment, while the relative pliable proximal and distal retention portions 12, 20 gently contact the septal tissue without penetration.
- the proximal retention struts 66 are longer than some of the distal retention struts 40. In some embodiments, all of the proximal retention struts are longer than the distal retention struts. In some embodiments, the distal retention struts 40 have a length of about 2-7mm. In some embodiments, the proximal retention struts 66 have a length of about 2-14mm.
- the specific length of the distal retention struts 40 and/or proximal retention struts 66 should be determined by, inter alia, the overall size of the device, which in turn is determined by the needs of a patient.
- the proximal retention struts 66 are configured so that, upon full deployment, its first section curves toward the septum, forming a space between a portion of the strut and septum, and the most radially outward portion of the proximal retention struts 66 is at or near the most radially outward portion of the distal retention struts 40 on the opposite side of the septum.
- the device 10 is fabricated from a tube.
- all portions of the device 10, such as the distal retention portion 12, the distal transitional portion 14, the core region 16, the proximal transitional portion 18, the proximal retention portion 20, and proximal retrieval portion 22, have a same thickness.
- the thickness of the tube, and thus the thickness of each portion of the device is from 0.005-0.007 inch (0.013 cm to 0.018cm).
- at least one portion of the device 10 has a different thickness than the rest of the device. This, in some circumstances, can be achieved by removing material from other portions.
- the secondary retrieval legs 76 orient longitudinally along the longitudinal axis of the core region 16. In some embodiments, two adjacent secondary retrieval legs 76 extend close to each other.
- the secondary retrieval strut 76 extends radially inwardly, forming a curved profile with the distal ends of the secondary retrieval legs 76 located at a radially outward location, and the proximal of the secondary retrieval legs 76 located at a radially inward location relative to the distal end of the secondary retrieval legs 76.
- the distal ends of the secondary retrieval legs 76 are separate from one another, as each of the distal ends connecting to the proximal end of a deployed proximal retention segment 60.
- the proximal ends of the secondary retrieval legs 76 are configured to be at locations radially inward from the distal ends of the secondary retrieval legs 76 and radially outward from the opening 24 of the deployed core region 16.
- the deployed secondary retrieval legs 76 are proximal to the deployed proximal retention segments 60. Looking from the proximal end of a deployed device, as illustrated in Figure 1 , every two joined deployed secondary retrieval legs 76 are located between two deployed proximal retention segments 60.
- the width of each portion, such as the distal retention portion 12, the distal transitional portion 14, the core region 16, the proximal transitional portion 18, the proximal retention portion 20, and proximal retrieval portion 22, of the device 10 is the same as the thickness of the portion.
- the width of the distal retention portion 12, the distal transitional portion 14, the core region 16, the proximal transitional portion 18, and the proximal retention portion 20, are greater than the thickness of these portions.
- the width of the proximal retrieval portion 22 is the same as the thickness.
- the curving and bending of such portions can be achieved in a controlled manner, without risking the struts being twisted during the process.
- the thickness and width can be the same.
- the thickness of each portion of the device ranges from about 0.003" to about 0.09" (0.008cm to 0.23cm).
- the retrieval eyelets 72 are configured to be attached to a flexible delivery mechanism.
- a delivery filament such as a wire or a suture, extends through one or more retrieval attachment mechanisms with both ends of the filament being controlled by a clinician. Upon deployment, one end of the delivery filament is loosened and the other end of the delivery filament is retracted proximally so that the entire flexible delivery filament is removed from the body.
- a flexible delivery filament allows the device fully deploy at a treatment location, while still under the control of the clinician, so that the deployment can be assessed and the device can be retrieved if necessary.
- the retrieval eyelets 72 are configured to be attached to a relatively rigid delivery mechanism.
- a delivery shaft with notches at its distal end for hosting the retrieval eyelets 72.
- the retrieval eyelets 72 is secured inside the notch, and upon deployment, the retrieval eyelets 72 are released from the notch.
- a relatively rigid delivery shaft can push the device distally inside the delivery catheter and to deploy device.
- the device 10 includes eight proximal retention segments 60, eight secondary retrieval legs 76, four primary retrieval legs 74, and two retrieval attachment mechanisms 72.
- Each retrieval attachment mechanism 72 joins a proximal junction formed by two adjacent primary retrieval legs 74.
- Each distal end 82 of the two adjacent primary retrieval legs 74 further joins a proximal junction 80 formed by two adjacent secondary retrieval legs 76.
- Each distal end 78 of the said two adjacent secondary retrieval legs 76 joins a proximal end 64 of a proximal retention segment 60.
- Figure 6 illustrates the proximal ends 84 of two adjacent primary retrieval legs 74 joining each other first and then joining the retrieval attachment mechanism 72
- proximal ends 84 of two adjacent primary retrieval legs 74 could join a retrieval attachment mechanism 72 individually, without joining to each other first.
- the exemplary illustration should not be viewed as limiting.
- the device 10 is pre-set into its deployed profile and stretched into an elongated profile, such as shown in Figure 3 , for percutaneous delivery. Upon deployment, the device will recover to its pre-set deployed configuration once free from constraint of the delivery catheter.
- the maximum ratio of the thickness (t) of a curved portion of the device e.g., the transition from proximal retention segments 60 to secondary retrieval legs 76
- the radius "R" of that curved portion is 0.12, i.e., t/2R ⁇ 12%. Maintaining this ratio will ensure the maximum recovery of the intended curvature.
- Figures 7-13 illustrate another exemplary pressure regulating device 100 for, e.g., treating elevated left atrial pressure in a patient's heart.
- Figure 7 is an end view of the deployed configuration of the device 100.
- Figure 8 is an exemplary deployed configuration of the device 100.
- Figure 9 is a side view of the deployed configuration of the device 100.
- Figure 10 shows device 100 in a delivery configuration in which all portions of the device 100 are aligned in a generally linear profile and the retrieval attachment mechanisms overlap with each other.
- Figure 11 is an illustrative view of a portion of the device 100 in flattened format solely for the purpose of showing various components of the device.
- Device 100 may be delivered via a delivery catheter (not shown) for deployment in the atrial septum of the patient's heart.
- the device 100 includes a distal retention portion 112, a distal transition portion 114, a core region 116, a proximal transition portion 118, a proximal retention portion 120, and a proximal retrieval portion 122.
- Core region 116, distal transition struts 134, and distal retention portion 112, proximal transition portion 118, proximal retention portion 120, and secondary retrieval struts 176 and retrieval attachment mechanisms 172 shown in Figures 7-11 share some similarity to those illustrated with respect to the device 10 described in connection with Figures 1-6 .
- the central core region 116 includes an opening 124 to permit blood to flow through the device from the left atrium to the right atrium.
- the proximal retention region 120 has a plurality of flexible retention segments 160 that atraumatically engage the septal wall in the right atrium
- the distal retention region 112 has a plurality of flexible retention segments 146 that atraumatically engage the septal wall in the left atrium.
- the proximal and distal retention regions may cooperate to apply a compressive force to the septal wall.
- the proximal and distal retention regions do not apply a compressive force to the septal wall.
- the core region may also apply a radially outward force on the portion of the septal wall through which it extends. In other embodiments, the core region does not apply a radially outward force on the portion of the septal wall through which it extends.
- the radial span of the distal retention region 112 in the deployed configuration may be the same as the radial span of the proximal retention region 120. In other embodiments, the radial span of the distal retention region 112 may be greater than the radial span of the proximal retention region to, e.g., account for the typically greater pressure in the left atrium compared to the pressure in the right atrium.
- the distal retention region has a general diameter of 8-20 mm upon deployment. In another embodiment, the deployed proximal retention region has a general diameter of 8-20 mm upon deployment. According to some embodiments, upon deployment, the diameter of the deployed core region of the device is about 25-50% of the overall diameter of the deployed distal retention region.
- the retrieval region 122 includes retrieval legs 174 extending proximally and radially inwardly from the radially outward ends of the proximal retention segments 160 via intermediate legs 176 disposed between the retrieval leg 174 and the proximal retention segments 160.
- each secondary retrieval leg 176 extends proximally from the proximal end of a proximal retention segment 160.
- a distal end of a secondary retrieval leg joins the proximal end of a proximal retention segment 160 where two adjacent proximal retention struts join.
- Loops or eyelets 172 at the ends of the retrieval legs 174 serve as connectors for the delivery and/or retrieval system.
- eyelets 172 are proximal to and radially outward from the outer boundary of the opening 124 and therefore out of the path of any blood flowing through opening 124.
- eyelets 172 are oriented in a plane generally parallel to the longitudinal axis of the core region 116.
- Figure 10 is a side view of device 100 in its collapsed delivery configuration. As shown, the radial dimensions of the proximal retention region 120, central core region 116 and distal retention region 112 are less in the delivery configuration than in the deployed configuration shown in Figures 7-9 .
- the retrieval legs 174 and eyelets 172 extend proximally from the proximal retention region and connect to a delivery or retrieval system (not shown).
- a delivery system advances device 100 through and out of a catheter.
- the distal retention region 114 of device 100 begins to self-expand in the left atrium.
- the core region 116 and proximal retention region 120 expand as they emerge from the catheter in the septal wall opening and right atrium, respectively, while the eyelets 172 of the retrieval legs 174 are still connected to the delivery system.
- distal retention segments 146, core region 116 and proximal retention segments 160 are substantially in their deployed configurations even while retrieval legs 174 extend proximally in an elongated profile into the delivery catheter (not shown) with the eyelets 172 overlapping each other and connected to a delivery system (not shown).
- retrieval legs 174 have emerged from the delivery catheter and have begun moving toward their expanded at-rest shapes; eyelets 172 are radially inward from their at-rest positions because they are still connected to the delivery system. This position is the retrieval configuration of device 100. After release from the delivery system, eyelets 172 move radially outward to their at-rest positions radially outside of the devices opening 124 (i.e., the deployed configuration shown in Figure 7 ).
- the retrieval device grasps eyelets 172, moving them radially inward. Device 100 is then pulled proximally into the retrieval catheter.
- portions of device 100 are arranged and configured to provide the desired bending behavior as device 100 emerges from and is drawn back into a delivery catheter, as shown in Figure 11 .
- Device 100 may be made with wavy patterns with hairpin turns, "V" shaped turns, open-cell or closed-cell designs.
- the diameter of the core region increases and the core region reduces in length, sometimes slightly.
- the overall length of the core region remains the same.
- the device 100 in its delivery configuration is configured to be delivered and deployed through a 5 French - 12 French catheter.
- the elongated device 100 has a diameter ranging from about 1 mm to about 4 mm
- the central core region 116 in a deployed configuration has a diameter ranging from about 3 mm to about 12 mm, or from about 110% to about 300% of that of the core region 116 in its delivery configuration.
- the struts of the shunt portion 116 have a width of about 0.005 inch to about 0.030 inch (0.013cm to 0.076cm).
- the gap between two adjacent portions of the core portion struts is from about 0" to about 0.01 0" (0cm to 0.025cm), and upon deployment, the gap between two adjacent portions of the struts is up to about 0.075" (0.191cm).
- the device 100 in its delivery configuration has an overall length of about 5-25 mm, with the length of the core region 116 being 0.5-5mm.
- the length of the core region 116 ranges from about 1 mm to about 7 mm, with the overall length of the device 100 ranging from about 3 mm to about 12mm.
- the length of the core region 116 of a deployed device ranges from about 30 to about 70% of the length of the device in the deployed profile.
- the bending location of device struts has a narrower width ("waist") than another portion, sometimes the remaining portions of the struts.
- the lead-ins from both directions generally have a curved configuration.
- the bending location has curved lead-ins from both ends, other geometries, shapes, or profiles for narrowing the strut width at the bending location could also be used.
- what has been disclosed should not be viewed as limiting to the scope of the present teaching.
- the waist has a width from about 0.003" to about 0.015" (0.008cm to 0.038cm), or from about 30% to about 110% of the width of the widest portion of the struts. Additionally, in order to control the bending direction, the width of the struts can be greater than the thickness. Additionally, the length of the distal transition portion, as well as the width of the waist could vary according to the overall size of the device and design criteria.
- the distal retention region 112 of device 100 Upon deployment in vivo, the distal retention region 112 of device 100 is configured to be deployed inside the left atrium with each of the distal retention segments 146 located at the left atrial side of the atrial septum. In certain embodiments, the distal retention opposes the left atrial side of the atrial septum. According to some embodiments, upon deployment, the distal retention region 112 forms a disc-like configuration, with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 146 contacting the atrial septum. In another embodiments, the distal retention region 112 forms an umbrella-like configuration with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 146 doming away from the atrial septum.
- one or more distal ends of the distal retention segments 146 can contact the atrial septum.
- the distal retention region 112 forms a generally straight slope profile with at least a portion, sometimes a substantial portion, of the surface area of each distal retention segment 146 not contacting the atrial septum.
- one or more distal ends of the distal retention segments 146 remain furthest away from the atrial septum.
- suitable profile could also be used.
- each distal retention segment 146 include a foot 152.
- the foot 152 is configured to prevent the distal ends of the distal retention segments 146 from penetrating, piercing, or eroding into the septal tissues.
- the foot is configured to provide a larger surface area for contacting the tissues and/or reducing the force that the distal retention segments 146 apply onto the tissues.
- the foot 152 is also configured to incorporate a radiopaque marker.
- the proximal transition portion 118 When the device 100 is at its delivery configuration, the proximal transition portion 118 has a small generally tubular profile, such as illustrated in Figure 10 , with adjacent struts packed closely and parallel to each other. The proximal transition portion 118 is also configured to transform from a delivery configuration to a deployed configuration. During such transition, a proximal section of the struts extends radially outwardly, and a distal section of the struts expands as the core region 116 expands radially into its deployed configuration.
- the proximal transition struts bend at a location so that the core region 116 of the device has a tubular profile at the distal end of the proximal transition struts, and the proximal retention region 120 of the device 100 have a radially outward umbrella-shaped profile that is generally at an angle, sometimes perpendicular, to the longitudinal axis of the core region 116 at the proximal end of the proximal transition struts.
- the bending location on the proximal transition struts has a narrower width ("waist") than another portion, sometimes the remaining portions, of the struts.
- the lead-ins from both direction have a generally curved configuration.
- the bending location has a generally curved led-ins from both ends of the waist, other geometries, shapes, or profiles for narrowing the strut width at the bending location could also be used. Thus what has been disclosed should not be viewed as limiting.
- the waist has a width from about 0.006" to about 0.0310" (0.015cm to 0.076cm), or from about 25 to about 80% of the width of the widest portion of the proximal transition struts.
- the width of the proximal transition struts can be greater than the thickness of the proximal transition struts.
- the proximal transition struts are shorter and narrower than the distal transition struts of the device.
- the proximal transition struts can have the same length and/or width as the distal transition struts.
- the device 100 can also have a proximal retention region 120.
- the proximal retention region 120 of the device 100 has an expanded umbrella-like profile when deployed, as illustrated in Figure 7 , and a collapsed generally tubular profile during delivery, as illustrated in Figure 10 .
- the proximal retention region 120 includes multiple proximal retention segments 160.
- each of the proximal retention segments is formed by two adjacent proximal retention struts extending proximally from the proximal end of a proximal transition strut. The distal ends of the two proximal retention struts are located side by side from each other with a gap in between.
- the distal ends of two proximal retention struts extend from the proximal end of two adjacent proximal transition struts to connect to each other, forming a proximal retention segment 160.
- the proximal retention segment 160 formed by two adjacent proximal retention struts are relatively elongated with two adjacent proximal retention struts extending close to each other; and in deployed configuration, the proximal retention segment 160 formed by two adjacent proximal retention struts are expanded in width and shortened in the overall length with the gap between two adjacent proximal retention struts widened.
- the proximal retention portion 120 when the device 100 is in its delivery configuration, the proximal retention portion 120 radially collapses with the proximal retention segments 160 orienting longitudinally along the longitudinal axis of the core region 116, and when the device 100 is in its deployed configuration, the proximal retention portion 120 radially expands with the proximal retention segment 160 curving distally.
- a first section of each proximal retention segment 160 curves distally toward the atrial septum forming a first curve
- a second section of each proximal retention segment 160 curves proximally away from the atrial septum forming a second curve, with a portion of each proximal retention segment 160 between the first and second sections of each proximal retention segment 160 contacting the septal tissue.
- the curved deployment configuration of the proximal retention region 120 allows the device to accommodate various atrial septum thickness.
- the curved proximal retention segments 160 can fully assume its pre-defined curved deployment configuration.
- the curved proximal retention segments 160 can oppose the atrial septum, and when the septum pushes back, the curved proximal retention segments 160 can deflect at their first curve while maintaining the device 100 in place.
- curving the second section of the deployed proximal retention region 120 away from the atrial septum enlarges the contacting surface area with the septal tissue, thereby preventing any trauma to the tissue.
- the second curve of the proximal retention segments 160 can start at any location near or at the proximal ends of each retention segment 160.
- the proximal retention region struts in a delivery configuration, have a similar width as the distal retention struts. In other embodiments, the proximal retention struts have a different width than the distal retention struts. In yet another embodiment, the width of the strut of the core region 116 is greater than that of the proximal retention struts and that of the distal retention struts, so that the core region 116 is more rigid than the proximal and distal retention portions 112, 120.
- the stiff core region 116 pushes the surrounding tissue radially outwardly, thereby maintaining the size of the opening for the treatment, while the relative pliable proximal and distal retention portions 112, 120 gently contact the septal tissue without penetration.
- the proximal retention struts are longer than some of the distal retention struts. In some embodiments, all of the proximal retention struts are longer than the distal retention struts. In some embodiments, the distal retention struts have a length of about 2-7mm. In some embodiments, the proximal retention struts have a length of about 2-14mm.
- the specific length of the distal retention struts and/or proximal retention struts should be determined by, inter alia, the overall size of the device, which in turn is determined by the needs of a patient.
- the proximal retention struts are configured so that, upon full deployment, its first section curves toward the septum, forming a space between a portion of the strut and septum, and the most radially outward portion of the proximal retention struts is at or near the most radially outward portion of the distal retention struts on the opposite side of the septum.
- the device 100 is fabricated from a tube.
- all portions of the device 100 such as the distal retention portion 112, the distal transitional portion 114, the central core region 116, the proximal transitional portion 118, the proximal retention portion 120, and proximal retrieval portion 122, have a same thickness.
- the thickness of the tube, and thus the thickness of each portion of the device is from 0.005-0.007 inch (0.013cm to 0.018cm).
- at least one portion of the device 100 has a different thickness than the rest of the device. This, in some circumstances, can be achieved by removing material from other portions.
- each portion such as the distal retention portion 112, the distal transitional portion 114, the core region 116, the proximal transitional portion 118, the proximal retention portion 120, and proximal retrieval portion 122, of the device 100 is the same as the thickness of the portion.
- the width of the distal retention portion 112, the distal transitional portion 114, the core region 116, the proximal transitional portion 118, and the proximal retention portion 120 are greater than the thickness of these portions.
- the width of the proximal retrieval portion 122 is the same as the thickness.
- the curving and bending of such portions can be achieved in a controlled manner, without risking the struts being twisted during the process.
- the thickness and width can be the same.
- the thickness of each portion of the device ranges from about 0.003" to about 0.09" (0.008cm to 0.23cm).
- the retrieval eyelets 172 are configured to be attached to a flexible delivery mechanism.
- a delivery filament such as a wire or a suture, extends through one or more retrieval attachment mechanisms with both ends of the filament being controlled by a clinician. Upon deployment, one end of the delivery filament is loosened and the other end of the delivery filament is retracted proximally so that the entire flexible delivery filament is removed from the body.
- a flexible delivery filament allows the device fully deploy at a treatment location, while still under the control of the clinician, so that the deployment can be assessed and the device can be retrieved if necessary.
- the retrieval eyelets 172 are configured to be attached to a relatively rigid delivery mechanism.
- a delivery shaft with notches at its distal end for hosting the retrieval eyelets 172.
- the retrieval eyelets 172 is secured inside the notch, and upon deployment, the retrieval eyelets 172 are released from the notch.
- a relatively rigid delivery shaft can push the device distally inside the delivery catheter and to deploy device.
- the device 100 is pre-set into its deployed profile and stretched into an elongated profile, such as shown in Figure 10 , for percutaneous delivery. Upon deployment, the device will recover to its pre-set deployed configuration once free from constraint of the delivery catheter.
- the maximum ratio of the thickness (t) of a curved portion of the device e.g., the transition from proximal retention segments 60 to secondary retrieval legs 76
- the radius "R" of that curved portion is 0.12, i.e., t/2R ⁇ 12%. Maintaining this ratio will ensure the maximum recovery of the intended curvature.
- Figures 14-17 show another embodiment of a pressure regulating device 410 for, e.g., treating elevated left atrial pressure in a patient's heart according to this invention.
- Figures 14-16 show the device 410 in a deployed configuration. In its delivery configuration (not shown), device 410 is collapsed into a generally tube-like configuration, such as shown in Figures 3 and 10 with respect to embodiments discussed above.
- a distal retention region 412 extends distally from a central core region 416 via a distal transition region 414, and a proximal retention region 420 extends proximally from core region 416 via a proximal transition region 418.
- the proximal transition portion 418 has a relatively longer overall length, and greater overall width, than prior embodiments.
- the geometrical center of the strut is hollowed out resulting a two adjacent struts 452, 454 in between the distal and proximal ends of the proximal transition portion 418.
- device 410 (including distal retention region 412, central core region 416 and proximal retention region 420) is radially compressed and axially elongated compared to the deployed configuration shown in Figures 14-16 .
- Device 410 may be delivered via a delivery catheter (not shown) for deployment in the atrial septum of the patient's heart.
- the central core region 416 includes an opening 424 to permit blood to flow through the device from the left atrium to the right atrium.
- the radially expanded proximal retention region 420 has a plurality of flexible retention segments 460 that atraumatically engage the septal wall in the right atrium
- the radially expanded distal retention region 412 has a plurality of flexible retention segments 446 that atraumatically engage the septal wall in the left atrium.
- the proximal and distal retention regions may cooperate to apply a compressive force to the septal wall.
- the proximal and distal retention regions do not apply a compressive force to the septal wall.
- the core region may also apply a radially outward force on the portion of the septal wall through which it extends. In other embodiments, the core region does not apply a radially outward force on the portion of the septal wall through which it extends.
- the radial span of the distal retention region 412 in the deployed configuration may be the same as the radial span of the proximal retention region 420. In other embodiments, the radial span of the distal retention region 412 may be greater than the radial span of the proximal retention region to, e.g., account for the typically greater pressure in the left atrium compared to the pressure in the right atrium.
- the distal retention region has a general diameter of 8-20 mm upon deployment. In another embodiment, the deployed proximal retention region has a general diameter of 8-20 mm upon deployment. According to some embodiments, upon deployment, the diameter of the deployed core region of the device is about 25-50% of the overall diameter of the deployed distal retention region.
- the retrieval region 422 includes retrieval legs 474 extending proximally and radially inwardly from the radially outward ends of the proximal retention segments 460, optionally via intermediate legs 476 disposed between the retrieval legs 474 and a junction 464, and the proximal retention segments 460.
- junction 464 has a relatively greater overall length and greater overall width. Similar to proximal transition portion 418, in order to reduce the mass of the junction 464, as well as reducing the size of the delivery profile, geometrical center of the junction 464 is hollowed out resulting a two adjacent struts 462, 460 in between the distal and proximal ends of the junction 464.
- Loops or eyelets 472 at the proximal ends of the retrieval legs 474 serve as connectors for the delivery and/or retrieval system. As shown in Figures 14-16 , in the device's deployed configuration the eyelets 472 are proximal to and radially outward from the outer boundary of the opening 424 and therefore out of the path of any blood flowing through opening 424. In this embodiment, eyelets 472 are oriented in a plane generally perpendicular to the longitudinal axis of the core region 416.
- a delivery system advances device 410 through and out of a catheter.
- the distal retention region 414 of device 410 begins to self-expand in the left atrium.
- the core region 416 and proximal retention region 420 expand as they emerge from the catheter in the septal wall opening and right atrium, respectively, all while the eyelets 472 of the retrieval legs 474 are still connected to the delivery system.
- Distal retention segments 446, core region 416 and proximal retention segments 460 are substantially in their deployed configurations even while retrieval legs 474 and 476 extend proximally into the delivery catheter (not shown).
- retrieval legs 474 and 476 begin moving toward their expanded at-rest shapes, while eyelets 472 remain radially inward (in the device's retrieval configuration) from their at-rest positions because they are still connected to the delivery system. After release from the delivery system, eyelets 472 move radially outward to their at-rest positions radially outside of the device's opening 424 (i.e., the deployed configuration shown in Figure 16 ).
- the retrieval device grasps eyelets 472, moving them radially inward. Device 410 is then pulled proximally into the retrieval catheter.
- portions of device 410 are arranged and configured to provide the desired bending behavior as device 410 emerges from and is drawn back into a delivery catheter, as shown in Figure 17 .
- Device 410 may be made with wavy patterns with hairpin turns, "V" shaped turns, open-cell or closed-cell designs.
- the diameter of the core region increases and the core region reduces in length, sometimes slightly.
- the overall length of the core region remains the same.
- the device 410 in its delivery configuration is configured to be delivered and deployed through a 5 French - 12 French catheter.
- the elongated device 410 has a diameter ranging from about 1 mm to about 4 mm
- the central core region 416 in a deployed configuration has a diameter ranging from about 3 mm to about 12 mm, or from about 110% to about 300% of that of the core region 416 in its delivery configuration.
- the struts of the shunt portion 416 have a width of about 0.005 inch to about 0.030 inch (0.001cm to 0.076cm).
- the gap between two adjacent portions of the core portion struts is from about 0" to about 0.01 0" (0cm to 0.025cm), and upon deployment, the gap between two adjacent portions of the struts is up to about 0.075 "(0.191cm).
- the device 410 in its delivery configuration has an overall length of about 5-25 mm, with the length of the core region 416 being 0.5-5mm.
- the length of the core region 416 ranges from about 1 mm to about 7 mm, with the overall length of the device 410 ranging from about 3 mm to about 12mm.
- the length of the core region 416 of a deployed device ranges from about 30 to about 70% of the length of the device in the deployed profile.
- the bending location of distal transition region 414 has a narrower width ("waist") than another portion, sometimes the remaining portions of the struts.
- the lead-ins from both directions generally have a curved configuration.
- the bending location has curved lead-ins from both ends, other geometries, shapes, or profiles for narrowing the strut width at the bending location could also be used.
- what has been disclosed should not be viewed as limiting to the scope of the present teaching.
- the waist has a width from about 0.003" to about 0.015" (0.008cm to 0.038cm), or from about 30% to about 110% of the width of the widest portion of the struts. Additionally, in order to control the bending direction, the width of the struts can be greater than the thickness. Additionally, the length of the distal transition portion, as well as the width of the waist could vary according to the overall size of the device and design criteria.
- the distal retention region 412 of device 410 Upon deployment in vivo, the distal retention region 412 of device 410 is configured to be deployed inside the left atrium with each of the distal retention segments 446 located at the left atrial side of the atrial septum. In certain embodiments, the distal retention opposes the left atrial side of the atrial septum. According to some embodiments, upon deployment, the distal retention region 412 forms a disc-like configuration, with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 446 contacting the atrial septum. In another embodiments, the distal retention region 412 forms an umbrella-like configuration with at least a portion, sometimes a substantial portion, of the surface area of each retention segment 446 doming away from the atrial septum.
- one or more distal ends of the distal retention segments 446 can contact the atrial septum.
- the distal retention region 412 forms a generally straight slope profile with at least a portion, sometimes a substantial portion, of the surface area of each distal retention segment 446 not contacting the atrial septum.
- one or more distal ends of the distal retention segments 446 remain furthest away from the atrial septum.
- suitable profile could also be used.
- each distal retention segment 446 include a foot 451.
- the foot 451 is configured to prevent the distal ends of the distal retention segments 446 from penetrating, piercing, or eroding into the septal tissues.
- the foot is configured to provide a larger surface area for contacting the tissues and/or reducing the force that the distal retention segments 446 apply onto the tissues.
- the foot 451 is also configured to incorporate a radiopaque marker.
- the proximal transition portion 418 When the device 410 is at its delivery configuration, the proximal transition portion 418 has a small generally tubular profile, with adjacent struts packed closely and parallel to each other. The proximal transition portion 418 is also configured to transform from a delivery configuration to a deployed configuration. During such transition, a proximal section of the struts extends radially outwardly, and a distal section of the struts expands as the core region 416 expands radially into its deployed configuration.
- the proximal transition struts bend at a location so that the core region 416 of the device has a tubular profile at the distal end of the proximal transition struts, and the proximal retention region 420 of the device 410 have a radially outward umbrella-shaped profile that is generally at an angle, sometimes perpendicular, to the longitudinal axis of the core region 416 at the proximal end of the proximal transition struts.
- the device 410 can also have a proximal retention region 420.
- the proximal retention region 420 of the device 410 has an expanded umbrella-like profile when deployed, as illustrated in Figures 14-16 , and a collapsed generally tubular profile during delivery.
- the proximal retention region 420 includes multiple proximal retention segments 460.
- each of the proximal retention segments is formed by two adjacent proximal retention struts extending proximally from the proximal end of a proximal transition strut. The distal ends of the two proximal retention struts are located side by side from each other with a gap in between.
- the distal ends of two proximal retention struts extend from the proximal end of two adjacent proximal transition struts to connect to each other, forming a proximal retention segment 460.
- the proximal retention segment 460 formed by two adjacent proximal retention struts are relatively elongated with two adjacent proximal retention struts extending close to each other; and in deployed configuration, the proximal retention segment 460 formed by two adjacent proximal retention struts are expanded in width and shortened in the overall length with the gap between two adjacent proximal retention struts widened.
- the proximal retention portion 420 when the device 410 is in its delivery configuration, the proximal retention portion 420 radially collapses with the proximal retention segments 460 orienting longitudinally along the longitudinal axis of the core region 416, and when the device 410 is in its deployed configuration, the proximal retention portion 420 radially expands with the proximal retention segment 460 curving distally.
- a first section of each proximal retention segment 460 curves distally toward the atrial septum forming a first curve
- a second section of each proximal retention segment 460 curves proximally away from the atrial septum forming a second curve, with a portion of each proximal retention segment 460 between the first and second sections of each proximal retention segment 460 contacting the septal tissue.
- the curved deployment configuration of the proximal retention region 420 allows the device to accommodate various atrial septum thickness.
- the curved proximal retention segments 460 can fully assume its pre-defined curved deployment configuration.
- the curved proximal retention segments 460 can oppose the atrial septum, and when the septum pushes back, the curved proximal retention segments 460 can deflect at their first curve while maintaining the device 410 in place.
- curving the second section of the deployed proximal retention region 420 away from the atrial septum enlarges the contacting surface area with the septal tissue, thereby preventing any trauma to the tissue.
- the second curve of the proximal retention segments 460 can start at any location near or at the proximal ends of each retention segment 460.
- the proximal retention region struts in a delivery configuration, have a similar width as the distal retention struts. In other embodiments, the proximal retention struts have a different width than the distal retention struts. In yet another embodiment, the width of the strut of the core region 416 is greater than that of the proximal retention struts and that of the distal retention struts, so that the core region 416 is more rigid than the proximal and distal retention portions 412, 420.
- the stiff core region 416 pushes the surrounding tissue radially outwardly, thereby maintaining the size of the opening for the treatment, while the relative pliable proximal and distal retention portions 412, 420 gently contact the septal tissue without penetration.
- the proximal retention struts are longer than some of the distal retention struts. In some embodiments, all of the proximal retention struts are longer than the distal retention struts. In some embodiments, the distal retention struts have a length of about 2-7mm. In some embodiments, the proximal retention struts have a length of about 2-14mm.
- the specific length of the distal retention struts and/or proximal retention struts should be determined by, inter alia, the overall size of the device, which in turn is determined by the needs of a patient.
- the proximal retention struts are configured so that, upon full deployment, its first section curves toward the septum, forming a space between a portion of the strut and septum, and the most radially outward portion of the proximal retention struts is at or near the most radially outward portion of the distal retention struts on the opposite side of the septum.
- the device 410 is fabricated from a tube.
- all portions of the device 410 such as the distal retention portion 412, the distal transitional portion 414, the central core region 416, the proximal transitional portion 418, the proximal retention portion 420, and proximal retrieval portion 422, have a same thickness.
- the thickness of the tube, and thus the thickness of each portion of the device is from 0.005-0.007 inch (0.013cm to 0.018cm).
- at least one portion of the device 410 has a different thickness than the rest of the device. This, in some circumstances, can be achieved by removing material from other portions.
- the width of the distal retention portion 412, the distal transitional portion 414, the core region 416, the proximal transitional portion 418, and the proximal retention portion 420 are greater than the thickness of these portions.
- the width of the proximal retrieval portion 422 is the same as the thickness. According to some embodiments, for portions of the device having a width greater than the thickness, the curving and bending of such portions can be achieved in a controlled manner, without risking the struts being twisted during the process. For other portions of the device where twisting is expected, or less concerning, such as the proximal retrieval portion, the thickness and width can be the same. According to some embodiments, the thickness of each portion of the device ranges from about 0.003" to about 009" (0.008cm to 0.23cm).
- the retrieval eyelets 472 are configured to be attached to a flexible delivery mechanism.
- a delivery filament such as a wire or a suture, extends through one or more retrieval attachment mechanisms with both ends of the filament being controlled by a clinician. Upon deployment, one end of the delivery filament is loosened and the other end of the delivery filament is retracted proximally so that the entire flexible delivery filament is removed from the body.
- a flexible delivery filament allows the device fully deploy at a treatment location, while still under the control of the clinician, so that the deployment can be assessed and the device can be retrieved if necessary.
- the retrieval eyelets 472 are configured to be attached to a relatively rigid delivery mechanism.
- a delivery shaft with notches at its distal end for hosting the retrieval eyelets 472.
- the retrieval eyelets 472 is secured inside the notch, and upon deployment, the retrieval eyelets 472 are released from the notch.
- a relatively rigid delivery shaft can push the device distally inside the delivery catheter and to deploy device.
- the device 410 is pre-set into its deployed profile and stretched into an elongated profile for percutaneous delivery. Upon deployment, the device will recover to its pre-set deployed configuration once free from constraint of the delivery catheter.
- the maximum ratio of the thickness (t) of a curved portion of the device e.g., the transition from proximal retention segments 460 to secondary retrieval legs 476) over two times of the radius "R" of the curved portion is 0.12, i.e., t/2R ⁇ 12%. Maintaining this ratio will ensure the maximum recovery of the intended curvature.
- FIGS. 18 and 19 illustrate two different configurations.
- struts 564 forming proximal retention segment 560 meet retrieval strut 576 proximal to curve between the tissue contact surface of retention segment 560 and strut 576, as shown by the arrow in Figure 18 .
- struts 664 forming proximal retention segment 660 meet retrieval strut 676 at the tissue contact surface of retention segment 660, as shown by the arrow in Figure 19 .
- Device 510 shown in Figure 18 is less likely to twist during retrieval than the device 610 shown in Figure 19 due at least in part to the different locations of these connection points.
- the device of the present teachings is manufactured by laser cutting a biocompatible metal tube.
- the device is made of a biocompatible metal or polymer.
- the entire device is made of a biocompatible metal or polymer.
- the device in its entirely or portion(s) thereof, for example, those with curved/bent deployment configuration is made of an elastic material, a super-elastic material, or a shape-memory alloy so that the above portions can be distorted into a generally straightened profile during the delivery process and resume and maintain its intended profile in vivo once it is deployed from a delivery catheter.
- the device is made of stainless steel, nitinol, Titanium, Elgiloy, Vitalium, Mobilium, Ticonium, Platinore, Stellite, Tantalum, Platium, Hastelloy, CoCrNi alloys (e.g., trade name Phynox), MP35N, or CoCrMo alloys, any other metallic alloys, or a mixture thereof.
- a part of the device or the entire device is made of a polymer, such as PTFE, UHMPE, HDPE, polypropylene, polysulfone, or other biocompatible plastic.
- the surface finish of the device can be textured to induce tissue response and tissue ingrowth for improved stabilization.
- the resorbable polymer includes polyactic acid, polyglycolic acid, polycaprolactone, a combination of two or more of the above or a variety of other resorbable polymers that are well known to those skilled in the art.
- the device is fabricated from a tubular form and then shaped to its final configuration.
- a sufficiently elastic and resilient material such as nitinol
- the structure is preformed into the finished shape and elastically deformed.
- the device is stowed in a delivery device during the delivery and the device elastically recovers its shape upon deployment.
- one, some, or all portions of the device are manually expanded to the desired diameter and/or curved to a pre-set shape.
- one, some, or all portions of the device is heat set in an oven while constrained to the desired shape.
- At least one portion of the device expands radially upon being deployed in vivo.
- the radial expansion of at least one portion of the device is due to the elastic nature of the material.
- the radial expansion of at least one portion of the device is due to its pre-set thermal shape memory of the material.
- at least one portion of the device is manually expanded radially via a balloon.
- one or more radio-opaque markers are used. Without attempting to limit to any particular function, these radio-opaque markers can be visualized by using radiographic imaging equipment such as X-ray, magnetic resonance, ultrasound, or other imaging techniques known to one of ordinarily skilled in the art.
- radiographic imaging equipment such as X-ray, magnetic resonance, ultrasound, or other imaging techniques known to one of ordinarily skilled in the art.
- One or more markers as disclosed herein can be applied to any part of a device or a delivery system of the present teachings.
- a radio-opaque marker can be weld, sewed, adhered, swaged riveted, otherwise placed, and secured in or on the device.
- the radio-opaque marker may be made of tantalum, tungsten, platinum, irridium, gold, or alloys of these materials or other materials that are known to those skilled in the art.
- the radio-opaque marker can also be made of numerous paramagnetic materials, including one or more elements with atomic numbers 21-29, 42, 44, and 58-70, such as chromium (III), manganese (II), iron (III), iron (II), cobalt (II), copper (II), nickel (II), praesodymium (III), neodymium (III), samarium (III), ytterbium (III), gadolinium (III), terbium (III), dysprosium (III), holmium (III) and erbium (III), or other MR visible materials that are known to those skilled in the arts.
- the devices described above may be delivered by delivery systems described, e.g., in US 2011/0071623 .
- the treatment starts with a septal puncture which creates an aperture in the atrial septum, and device as described above is then deployed across the aperture. Since the resulting aperture is essentially a fresh wound, the body's natural healing process will start.
- the tissue or cell growth can extend through the openings of the device and into the tubular opening of the shunt portion of the device. In some situation, the opening created by the shunt portion of the device may be blocked or otherwise re-occluded by the tissue growth. Thus, such healing process would then undo all intended treatment over time.
- the entirety or at least a portion of the device is covered with a biocompatible barrier, for example, to prevent excessive tissue ingrowth.
- a biocompatible barrier for example, to prevent excessive tissue ingrowth.
- only one side of the luminal surface is covered. Advantages of covering one side of the luminal surface include the possibility of enhanced healing. It is known that living cells infiltrate a sufficiently porous covering material, such as ePTFE, and that microcapillaries may form within and across the barrier wall so that a living intima is formed along the luminal surface.
- the luminal surface of the shunt portion of the device is covered with a biocompatible barrier not only to prevent tissue ingrowth but also provide a thrombi-resistant to the shunt lumen.
- the configuration may depend on the application of the device. In some applications, for example, where a large aperture with a greater pressure differential between the two atria is present or created, placing the covering on the luminal surface (facing the blood flow) may result in an advantageous laminar flow of the blood-blood flow without significant turbulence.
- Another advantage of using only luminal covering can be improved anchoring of the device within the aperture afforded by interactions between the bare structure of the shunt portion of the device and the tissue wall surrounding the aperture.
- the abluminal surface (facing the tissue) of the shunt portion of the device is covered with a biocompatible barrier in order to prevent tissue ingrowth.
- placing barrier material only on the abluminal surface of the shunt portion has some benefit to patients. For example, contacting blood with a metal structure may result in local, limited thrombosis. Thus, by covering the abluminal surface of the shunt portion of the device could limit thrombosis, resulting in enhanced healing without occlusion of the shunt lumen.
- the covering is placed on both the luminal and abluminal surfaces of the shunt portion.
- the covering must be attached to the device to prevent it from detaching and perhaps forming emboli in the heart.
- the material used as a barrier could be attach to a device through direct bonding between the device and material. For material that does not adhere well to a device, it can be made to bond to itself.
- one effective method of affixing the ePTFE cover is to place ePTFE covers in contact with both the abluminal and luminal surfaces of the shunt portion of the device so that one ePTFE covering can bond to the other where the ePTFE coverings come to contact through the openings in the shunt portion.
- porosity of material can be selected to achieve the best treatment result.
- material with small pores, or even no pores could be used to encapsulate the abluminal side so that tissue encroachment can be prevented, and material with a larger pore size than that of the material covering the abluminal surface of the shunt portion could be used to cover the luminal surface in order to facilitate cell coverage and endothelialization of the luminal side to produce a thromboresistent surface in direct blood contact.
- the encapsulating layers are made of a flexible, biocompatible, non-absorbable polymeric material (i.e., a material that does not dissolve after implanted in the body).
- a flexible, biocompatible, non-absorbable polymeric material i.e., a material that does not dissolve after implanted in the body.
- materials include, without limitation, expanded polytetrafluoroethylene (ePTFE), unexpanded porous PTFE, woven or knitted polyester or expanded PTFE yarns, ultrahigh molecular weight polyethylene (UHMWPE), other polyolefins, composite materials such as ePTFE with PTFE fibers, or UHMWPE film with embedded UHMWPE fibers, polyimides, silicones, polyurethane, hydrogels, fluorinated ethylene polypropylene (FEP), polypropylfluorinated amines (PFA), other related fluorinated polymers.
- ePTFE expanded polytetrafluoroethylene
- the encapsulating layer could also be made of other material such as polyurethanes, metallic materials, polyvinyl alcohol (PVA), extracellular matrix (ECM) isolated from a mammalian tissue, or other bioengineered materials, or other natural materials (e.g., collagen), or combinations of these materials.
- Suitable material also include nonwoven fabrics, electrospun, dry spun materials or various combinations thereof.
- the surface of the encapsulation material can be modified with biological, pharmaceutical and/or other active ingredients, such as anti-coagulants, anti-thrombogenic agents, cells, growth factors and/or drugs to diminish calcifications, protein deposition, and thrombus, which control and direct tissue growth by stimulating an irritation response to induce cell proliferation in one area and discourage cell proliferation in the other.
- biological, pharmaceutical and/or other active ingredients such as anti-coagulants, anti-thrombogenic agents, cells, growth factors and/or drugs to diminish calcifications, protein deposition, and thrombus, which control and direct tissue growth by stimulating an irritation response to induce cell proliferation in one area and discourage cell proliferation in the other.
- the methods, which are not part of the invention, and devices disclosed herein are useful for treating various symptoms of heart failures, in particular diastolic heart failures, by reducing the pressure in the left atrium and pulmonary veins.
- devices according to the present teachings could be used to regulate pressure in other parts of the heart and/or vascular portions of the body.
- the devices disclosed herein can be deployed on the septum between the left and right atria, the left and right ventricles, the left atrium and the coronary sinus, and the like.
Claims (8)
- Vorrichtung zum Implantieren in einem Vorhofseptum eines Patienten, wobei die Vorrichtung Folgendes umfasst: eine Kernregion (16) mit mehreren Kernsegmenten, die eine zentrale Öffnung (24) umgeben, wobei die Kernregion (16) zum Anordnen in einer Öffnung im Vorhofseptum ausgelegt und konfiguriert ist, eine distale Halteregion (12) mit mehreren distalen Haltesegmenten (46), die sich von den Kernsegmenten erstrecken, wobei die distalen Haltesegmente (46) zum Eingreifen in Gewebe auf einer linken Vorhofseite der Septumswand ausgelegt sind, eine proximale Halteregion (20) mit mehreren proximalen Haltesegmenten (60), die sich von den Kernsegmenten erstrecken, wobei die proximalen Haltesegmente (60) zum Eingreifen in Gewebe auf einer rechten Vorhofseite der Septumswand ausgelegt sind, und eine Rückholregion (22) mit mehreren Rückholelementen (74), die sich von den proximalen Haltesegmenten (60) erstrecken, wobei jedes Rückholelement (74) einen Verbinder (72) an einem proximalen Ende umfasst, wobei der Verbinder (72) zum Verbinden mit einem Zuführungssystem ausgelegt ist, wobei die Vorrichtung eine zusammengefaltete Zuführungskonfiguration sowie eine erste und eine zweite Konfiguration aufweist, wobei in der ersten Konfiguration die distale Halteregion (12), die Kernregion (16) und die proximale Halteregion (20) zum Eingreifen in das Vorhofseptum konfiguriert sind, während die Verbinder (72) am proximalen Ende der Rückholregion (22) so angeordnet sind, dass sie mit dem Zuführungssystem verbunden werden können, und wobei in der zweiten Konfiguration die distale Halteregion (12), die Kernregion (16) und die proximale Halteregion (20) zum Eingreifen in das Vorhofseptum konfiguriert sind, während die Verbinder (72) am proximalen Ende der Rückholregion (20) radial auswärts von der zentralen Öffnung (24) der Kernregion (16) angeordnet und proximal von den proximalen Haltesegmenten (60) beabstandet sind, wobei die genannte Vorrichtung dadurch gekennzeichnet ist, dass sich die Verbinder (72) von einem Ende der Rückholelemente (74) in der zweiten Konfiguration radial einwärts erstrecken.
- Vorrichtung nach Anspruch 1, wobei die Verbinder (72) in der ersten Konfiguration weiter radial einwärts angeordnet sind als in der zweiten Konfiguration.
- Vorrichtung nach Anspruch 1, wobei die Rückholregion (22) zwei Rückholelemente (74) umfasst.
- Vorrichtung nach Anspruch 1, wobei die Rückholregion (22) vier Rückholelemente (74) umfasst.
- Vorrichtung nach Anspruch 1, wobei die Verbinder Ösen (72) umfassen.
- Vorrichtung nach Anspruch 1, wobei sich jeder Verbinder (72) in der ersten Konfiguration distal von einem Ende des assoziierten Rückholelements (74) erstreckt.
- Vorrichtung nach Anspruch 1, wobei die Vorrichtung ferner eine Rückholkonfiguration hat, in der die Verbinder (72) radial einwärts von einer Position in der zweiten Konfiguration angeordnet sind und die proximalen und distalen Haltesegmente (60, 46) jeweils in im Wesentlichen derselben Position sind wie in der zweiten Konfiguration.
- Vorrichtung nach Anspruch 7, wobei sich die Rückholelemente (74) in der ersten Konfiguration von der proximalen Halteregion (22) proximal weiter erstrecken als in der Rückholkonfiguration.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201462028286P | 2014-07-23 | 2014-07-23 | |
US201562167624P | 2015-05-28 | 2015-05-28 | |
PCT/US2015/041777 WO2016014821A1 (en) | 2014-07-23 | 2015-07-23 | Devices and methods for treating heart failure |
Publications (3)
Publication Number | Publication Date |
---|---|
EP3171786A1 EP3171786A1 (de) | 2017-05-31 |
EP3171786A4 EP3171786A4 (de) | 2017-07-05 |
EP3171786B1 true EP3171786B1 (de) | 2020-05-13 |
Family
ID=55163772
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP15824456.6A Active EP3171786B1 (de) | 2014-07-23 | 2015-07-23 | Vorrichtungen zur behandlung von herzinsuffizienz |
Country Status (5)
Country | Link |
---|---|
US (1) | US10632292B2 (de) |
EP (1) | EP3171786B1 (de) |
JP (1) | JP6799526B2 (de) |
CA (1) | CA2955389C (de) |
WO (1) | WO2016014821A1 (de) |
Families Citing this family (73)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CA2554595C (en) | 2004-02-03 | 2016-03-29 | Atria Medical Inc. | Device and method for controlling in-vivo pressure |
WO2007083288A2 (en) | 2006-01-23 | 2007-07-26 | Atria Medical Inc. | Heart anchor device |
US20110257723A1 (en) | 2006-11-07 | 2011-10-20 | Dc Devices, Inc. | Devices and methods for coronary sinus pressure relief |
US9232997B2 (en) | 2006-11-07 | 2016-01-12 | Corvia Medical, Inc. | Devices and methods for retrievable intra-atrial implants |
WO2008055301A1 (en) | 2006-11-07 | 2008-05-15 | Univ Sydney | Devices and methods for the treatment of heart failure |
US8745845B2 (en) | 2006-11-07 | 2014-06-10 | Dc Devices, Inc. | Methods for mounting a prosthesis onto a delivery device |
US8652202B2 (en) | 2008-08-22 | 2014-02-18 | Edwards Lifesciences Corporation | Prosthetic heart valve and delivery apparatus |
US20210161637A1 (en) | 2009-05-04 | 2021-06-03 | V-Wave Ltd. | Shunt for redistributing atrial blood volume |
US8449599B2 (en) | 2009-12-04 | 2013-05-28 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
EP2673038B1 (de) | 2011-02-10 | 2017-07-19 | Corvia Medical, Inc. | Vorrichtung zur erzeugung und aufrechterhaltung einer öffnung für intra-atriale druckentlastung |
US11135054B2 (en) | 2011-07-28 | 2021-10-05 | V-Wave Ltd. | Interatrial shunts having biodegradable material, and methods of making and using same |
US8951223B2 (en) | 2011-12-22 | 2015-02-10 | Dc Devices, Inc. | Methods and devices for intra-atrial shunts having adjustable sizes |
WO2014188279A2 (en) | 2013-05-21 | 2014-11-27 | V-Wave Ltd. | Apparatus and methods for delivering devices for reducing left atrial pressure |
US10675450B2 (en) | 2014-03-12 | 2020-06-09 | Corvia Medical, Inc. | Devices and methods for treating heart failure |
US10524792B2 (en) | 2014-12-04 | 2020-01-07 | Edwards Lifesciences Corporation | Percutaneous clip for repairing a heart valve |
EP3291773A4 (de) | 2015-05-07 | 2019-05-01 | The Medical Research, Infrastructure, And Health Services Fund Of The Tel Aviv Medical Center | Temporäre interatriale shunts |
EP3738551A1 (de) | 2015-05-14 | 2020-11-18 | Edwards Lifesciences Corporation | Herzklappendichtungsvorrichtungen und einführungsvorrichtungen dafür |
US10531866B2 (en) | 2016-02-16 | 2020-01-14 | Cardiovalve Ltd. | Techniques for providing a replacement valve and transseptal communication |
US10799676B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10799675B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Cam controlled multi-direction steerable handles |
US10799677B2 (en) | 2016-03-21 | 2020-10-13 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10835714B2 (en) | 2016-03-21 | 2020-11-17 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US11219746B2 (en) | 2016-03-21 | 2022-01-11 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US20170340460A1 (en) | 2016-05-31 | 2017-11-30 | V-Wave Ltd. | Systems and methods for making encapsulated hourglass shaped stents |
US10835394B2 (en) | 2016-05-31 | 2020-11-17 | V-Wave, Ltd. | Systems and methods for making encapsulated hourglass shaped stents |
US10973638B2 (en) | 2016-07-07 | 2021-04-13 | Edwards Lifesciences Corporation | Device and method for treating vascular insufficiency |
US11304698B2 (en) | 2016-07-25 | 2022-04-19 | Virender K. Sharma | Cardiac shunt device and delivery system |
US10154844B2 (en) | 2016-07-25 | 2018-12-18 | Virender K. Sharma | Magnetic anastomosis device and delivery system |
US10653862B2 (en) | 2016-11-07 | 2020-05-19 | Edwards Lifesciences Corporation | Apparatus for the introduction and manipulation of multiple telescoping catheters |
US10905554B2 (en) | 2017-01-05 | 2021-02-02 | Edwards Lifesciences Corporation | Heart valve coaptation device |
WO2018132549A1 (en) | 2017-01-11 | 2018-07-19 | Sharma Virender K | Cardiac shunt device and delivery system |
US11135410B2 (en) * | 2017-02-26 | 2021-10-05 | Corvia Medical, Inc. | Devices and methods for treating heart failure |
US11291807B2 (en) | 2017-03-03 | 2022-04-05 | V-Wave Ltd. | Asymmetric shunt for redistributing atrial blood volume |
CA3054891A1 (en) | 2017-03-03 | 2018-09-07 | V-Wave Ltd. | Shunt for redistributing atrial blood volume |
US11224511B2 (en) | 2017-04-18 | 2022-01-18 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
KR20230121168A (ko) | 2017-04-18 | 2023-08-17 | 에드워즈 라이프사이언시스 코포레이션 | 심장 판막 밀봉 장치 및 그를 위한 전달 장치 |
US10799312B2 (en) | 2017-04-28 | 2020-10-13 | Edwards Lifesciences Corporation | Medical device stabilizing apparatus and method of use |
US10959846B2 (en) | 2017-05-10 | 2021-03-30 | Edwards Lifesciences Corporation | Mitral valve spacer device |
US11051940B2 (en) | 2017-09-07 | 2021-07-06 | Edwards Lifesciences Corporation | Prosthetic spacer device for heart valve |
US11065117B2 (en) | 2017-09-08 | 2021-07-20 | Edwards Lifesciences Corporation | Axisymmetric adjustable device for treating mitral regurgitation |
US11040174B2 (en) | 2017-09-19 | 2021-06-22 | Edwards Lifesciences Corporation | Multi-direction steerable handles for steering catheters |
US10238493B1 (en) | 2018-01-09 | 2019-03-26 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10973639B2 (en) | 2018-01-09 | 2021-04-13 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
SG11202006509SA (en) | 2018-01-09 | 2020-08-28 | Edwards Lifesciences Corp | Native valve repair devices and procedures |
US10123873B1 (en) | 2018-01-09 | 2018-11-13 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10159570B1 (en) | 2018-01-09 | 2018-12-25 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10507109B2 (en) | 2018-01-09 | 2019-12-17 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10076415B1 (en) | 2018-01-09 | 2018-09-18 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10245144B1 (en) | 2018-01-09 | 2019-04-02 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10111751B1 (en) | 2018-01-09 | 2018-10-30 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10105222B1 (en) | 2018-01-09 | 2018-10-23 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10136993B1 (en) | 2018-01-09 | 2018-11-27 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US10231837B1 (en) | 2018-01-09 | 2019-03-19 | Edwards Lifesciences Corporation | Native valve repair devices and procedures |
US11458287B2 (en) | 2018-01-20 | 2022-10-04 | V-Wave Ltd. | Devices with dimensions that can be reduced and increased in vivo, and methods of making and using the same |
US10898698B1 (en) | 2020-05-04 | 2021-01-26 | V-Wave Ltd. | Devices with dimensions that can be reduced and increased in vivo, and methods of making and using the same |
WO2019142152A1 (en) | 2018-01-20 | 2019-07-25 | V-Wave Ltd. | Devices and methods for providing passage between heart chambers |
WO2019189079A1 (ja) * | 2018-03-29 | 2019-10-03 | テルモ株式会社 | 医療デバイス |
US11389297B2 (en) | 2018-04-12 | 2022-07-19 | Edwards Lifesciences Corporation | Mitral valve spacer device |
US11207181B2 (en) | 2018-04-18 | 2021-12-28 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
US10945844B2 (en) | 2018-10-10 | 2021-03-16 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
MX2021009464A (es) | 2019-02-14 | 2021-09-10 | Edwards Lifesciences Corp | Dispositivos de sellado de valvulas cardiacas y dispositivos de suministro para los mismos. |
US11612385B2 (en) | 2019-04-03 | 2023-03-28 | V-Wave Ltd. | Systems and methods for delivering implantable devices across an atrial septum |
EP3972499A1 (de) | 2019-05-20 | 2022-03-30 | V-Wave Ltd. | Systeme und verfahren zur erzeugung eines interatrialen shunts |
JP2022547936A (ja) | 2019-09-09 | 2022-11-16 | シファメド・ホールディングス・エルエルシー | 調整可能なシャントならびに関連システム及び方法 |
WO2021113670A1 (en) | 2019-12-05 | 2021-06-10 | Shifamed Holdings, Llc | Implantable shunt systems and methods |
EP4138649A4 (de) | 2020-04-23 | 2024-04-17 | Shifamed Holdings Llc | Intrakardiale sensoren mit schaltbaren konfigurationen und zugehörige systeme und verfahren |
WO2022046921A1 (en) | 2020-08-25 | 2022-03-03 | Shifamed Holdings, Llc | Adjustable interatrial shunts and associated systems and methods |
EP4243915A1 (de) | 2020-11-12 | 2023-09-20 | Shifamed Holdings, LLC | Einstellbare implantierbare vorrichtungen und zugehörige verfahren |
US11234702B1 (en) | 2020-11-13 | 2022-02-01 | V-Wave Ltd. | Interatrial shunt having physiologic sensor |
CN112603617B (zh) * | 2020-12-17 | 2024-03-22 | 杭州诺生医疗科技有限公司 | 心房分流器械 |
WO2022143326A1 (zh) * | 2020-12-30 | 2022-07-07 | 杭州德晋医疗科技有限公司 | 左心室减容装置、左心室减容系统及左心室减容方法 |
CA3231663A1 (en) * | 2021-09-16 | 2023-03-23 | David Dudzinski | Transcatheter atrial septal closure device |
WO2023199267A1 (en) | 2022-04-14 | 2023-10-19 | V-Wave Ltd. | Interatrial shunt with expanded neck region |
Family Cites Families (384)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3874388A (en) | 1973-02-12 | 1975-04-01 | Ochsner Med Found Alton | Shunt defect closure system |
US3837345A (en) | 1973-08-31 | 1974-09-24 | A Matar | Venous valve snipper |
US4018228A (en) | 1975-02-24 | 1977-04-19 | Goosen Carl C | Surgical punch apparatus |
US4491986A (en) | 1976-05-12 | 1985-01-08 | Shlomo Gabbay | Heart valve |
US4373216A (en) | 1980-10-27 | 1983-02-15 | Hemex, Inc. | Heart valves having edge-guided occluders |
JPS5827935U (ja) | 1981-08-18 | 1983-02-23 | 株式会社村田製作所 | 混成集積回路装置 |
US4705507A (en) | 1984-05-02 | 1987-11-10 | Boyles Paul W | Arterial catheter means |
US4655217A (en) | 1985-10-11 | 1987-04-07 | Reed Matt H | Method and apparatus for disabling vein valves in-situ |
US5478353A (en) | 1987-05-14 | 1995-12-26 | Yoon; Inbae | Suture tie device system and method for suturing anatomical tissue proximate an opening |
JP2710355B2 (ja) | 1988-09-20 | 1998-02-10 | 日本ゼオン株式会社 | 医用弁装置 |
JP2754067B2 (ja) | 1989-01-17 | 1998-05-20 | 日本ゼオン株式会社 | 医療用体壁穴栓塞治具 |
US5674192A (en) | 1990-12-28 | 1997-10-07 | Boston Scientific Corporation | Drug delivery |
US5171233A (en) | 1990-04-25 | 1992-12-15 | Microvena Corporation | Snare-type probe |
US5100423A (en) | 1990-08-21 | 1992-03-31 | Medical Engineering & Development Institute, Inc. | Ablation catheter |
US5108420A (en) | 1991-02-01 | 1992-04-28 | Temple University | Aperture occlusion device |
US5697882A (en) | 1992-01-07 | 1997-12-16 | Arthrocare Corporation | System and method for electrosurgical cutting and ablation |
DE69334196T2 (de) | 1992-01-21 | 2009-01-02 | Regents Of The University Of Minnesota, Minneapolis | Verschlusseinrichtung eines Septumschadens |
US5332402A (en) | 1992-05-12 | 1994-07-26 | Teitelbaum George P | Percutaneously-inserted cardiac valve |
WO1994006357A1 (en) | 1992-09-23 | 1994-03-31 | Target Therapeutics, Inc. | Medical retrieval device |
US5304184A (en) | 1992-10-19 | 1994-04-19 | Indiana University Foundation | Apparatus and method for positive closure of an internal tissue membrane opening |
US5429144A (en) | 1992-10-30 | 1995-07-04 | Wilk; Peter J. | Coronary artery by-pass method |
CA2102084A1 (en) | 1992-11-09 | 1994-05-10 | Howard C. Topel | Surgical cutting instrument for coring tissue affixed thereto |
US5284488A (en) | 1992-12-23 | 1994-02-08 | Sideris Eleftherios B | Adjustable devices for the occlusion of cardiac defects |
US5464449A (en) | 1993-07-08 | 1995-11-07 | Thomas J. Fogarty | Internal graft prosthesis and delivery system |
US5683411A (en) | 1994-04-06 | 1997-11-04 | William Cook Europe A/S | Medical article for implantation into the vascular system of a patient |
GB9408314D0 (en) | 1994-04-27 | 1994-06-15 | Cardio Carbon Co Ltd | Heart valve prosthesis |
US5725552A (en) | 1994-07-08 | 1998-03-10 | Aga Medical Corporation | Percutaneous catheter directed intravascular occlusion devices |
US6123715A (en) | 1994-07-08 | 2000-09-26 | Amplatz; Curtis | Method of forming medical devices; intravascular occlusion devices |
WO1996001591A1 (en) | 1994-07-08 | 1996-01-25 | Microvena Corporation | Method of forming medical devices; intravascular occlusion devices |
US5846261A (en) | 1994-07-08 | 1998-12-08 | Aga Medical Corp. | Percutaneous catheter directed occlusion devices |
US5433727A (en) | 1994-08-16 | 1995-07-18 | Sideris; Eleftherios B. | Centering buttoned device for the occlusion of large defects for occluding |
ZA958860B (en) | 1994-10-21 | 1997-04-18 | St Jude Medical | Rotatable cuff assembly for a heart valve prosthesis |
US5556386A (en) | 1995-04-03 | 1996-09-17 | Research Medical, Inc. | Medical pressure relief valve |
US5556408A (en) | 1995-04-27 | 1996-09-17 | Interventional Technologies Inc. | Expandable and compressible atherectomy cutter |
DE69635659T2 (de) | 1995-06-01 | 2006-07-06 | Meadox Medicals, Inc. | Implantierbare intraluminale prothese |
US5702412A (en) | 1995-10-03 | 1997-12-30 | Cedars-Sinai Medical Center | Method and devices for performing vascular anastomosis |
JPH11514269A (ja) | 1995-10-13 | 1999-12-07 | トランスバスキュラー インコーポレイテッド | 動脈閉塞にバイパスを形成するためのおよび/またはその他の経血管的手法を実施するための方法および装置 |
US6283983B1 (en) | 1995-10-13 | 2001-09-04 | Transvascular, Inc. | Percutaneous in-situ coronary bypass method and apparatus |
DE69735530T2 (de) | 1996-01-04 | 2006-08-17 | Chuter, Timothy A.M. Dr., Atherton | Flachdrahtstent |
US6168622B1 (en) | 1996-01-24 | 2001-01-02 | Microvena Corporation | Method and apparatus for occluding aneurysms |
DE69724255T2 (de) | 1996-02-02 | 2004-06-03 | Transvascular, Inc., Menlo Park | System für interstitielle transvaskuläre chirurgische eingriffe |
DE19604817C2 (de) | 1996-02-09 | 2003-06-12 | Pfm Prod Fuer Die Med Ag | Vorrichtung zum Verschließen von Defektöffnungen im menschlichen oder tierischen Körper |
IL117472A0 (en) | 1996-03-13 | 1996-07-23 | Instent Israel Ltd | Radiopaque stent markers |
DE19621099C2 (de) | 1996-05-24 | 1999-05-20 | Sulzer Osypka Gmbh | Vorrichtung mit einem Katheter und einer von der Innenseite in die Herzwand einstechbaren Nadel als Hochfrequenzelektrode |
US5755682A (en) | 1996-08-13 | 1998-05-26 | Heartstent Corporation | Method and apparatus for performing coronary artery bypass surgery |
WO1998008456A1 (en) | 1996-08-26 | 1998-03-05 | Transvascular, Inc. | Methods and apparatus for transmyocardial direct coronary revascularization |
US5741297A (en) | 1996-08-28 | 1998-04-21 | Simon; Morris | Daisy occluder and method for septal defect repair |
US5655548A (en) | 1996-09-16 | 1997-08-12 | Circulation, Inc. | Method for treatment of ischemic heart disease by providing transvenous myocardial perfusion |
US6258119B1 (en) | 1996-11-07 | 2001-07-10 | Myocardial Stents, Inc. | Implant device for trans myocardial revascularization |
US6395017B1 (en) | 1996-11-15 | 2002-05-28 | C. R. Bard, Inc. | Endoprosthesis delivery catheter with sequential stage control |
US6050936A (en) | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US5893369A (en) | 1997-02-24 | 1999-04-13 | Lemole; Gerald M. | Procedure for bypassing an occlusion in a blood vessel |
US5954761A (en) | 1997-03-25 | 1999-09-21 | Intermedics Inc. | Implantable endocardial lead assembly having a stent |
US6245103B1 (en) | 1997-08-01 | 2001-06-12 | Schneider (Usa) Inc | Bioabsorbable self-expanding stent |
US6174330B1 (en) | 1997-08-01 | 2001-01-16 | Schneider (Usa) Inc | Bioabsorbable marker having radiopaque constituents |
US6120534A (en) | 1997-10-29 | 2000-09-19 | Ruiz; Carlos E. | Endoluminal prosthesis having adjustable constriction |
US6416490B1 (en) | 1997-11-04 | 2002-07-09 | Scimed Life Systems, Inc. | PMR device and method |
US6286512B1 (en) | 1997-12-30 | 2001-09-11 | Cardiodyne, Inc. | Electrosurgical device and procedure for forming a channel within tissue |
US6193734B1 (en) | 1998-01-23 | 2001-02-27 | Heartport, Inc. | System for performing vascular anastomoses |
EP1051128B1 (de) | 1998-01-30 | 2006-03-15 | St. Jude Medical ATG, Inc. | Medizinischer transplantatverbinder oder stopfen sowie verfahren zu ihrer herstellung |
US5944738A (en) | 1998-02-06 | 1999-08-31 | Aga Medical Corporation | Percutaneous catheter directed constricting occlusion device |
US6352543B1 (en) | 2000-04-29 | 2002-03-05 | Ventrica, Inc. | Methods for forming anastomoses using magnetic force |
US6651670B2 (en) | 1998-02-13 | 2003-11-25 | Ventrica, Inc. | Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication |
DE59812219D1 (de) | 1998-03-04 | 2004-12-09 | Schneider Europ Gmbh Buelach | Vorrichtung zum Einführen einer Endoprothese in einen Katheterschaft |
US6383195B1 (en) | 1998-04-13 | 2002-05-07 | Endoline, Inc. | Laparoscopic specimen removal apparatus |
US6059827A (en) | 1998-05-04 | 2000-05-09 | Axya Medical, Inc. | Sutureless cardiac valve prosthesis, and devices and methods for implanting them |
US20010027287A1 (en) | 1998-05-26 | 2001-10-04 | Trans Vascular, Inc. | Apparatus for providing coronary retroperfusion and/or left ventricular assist and methods of use |
US6254636B1 (en) | 1998-06-26 | 2001-07-03 | St. Jude Medical, Inc. | Single suture biological tissue aortic stentless valve |
SE512225C2 (sv) | 1998-06-26 | 2000-02-14 | Jouko Haverinen | Fixtur |
US6210338B1 (en) | 1998-08-21 | 2001-04-03 | Aga Medical Corp. | Sizing catheter for measuring cardiovascular structures |
US6241678B1 (en) | 1998-08-21 | 2001-06-05 | Aga Medical Corporation | Sizing catheter for measuring septal defects |
US6641610B2 (en) | 1998-09-10 | 2003-11-04 | Percardia, Inc. | Valve designs for left ventricular conduits |
US6290728B1 (en) | 1998-09-10 | 2001-09-18 | Percardia, Inc. | Designs for left ventricular conduit |
US6508252B1 (en) | 1998-11-06 | 2003-01-21 | St. Jude Medical Atg, Inc. | Medical grafting methods and apparatus |
US7044134B2 (en) | 1999-11-08 | 2006-05-16 | Ev3 Sunnyvale, Inc | Method of implanting a device in the left atrial appendage |
US6152937A (en) | 1998-11-06 | 2000-11-28 | St. Jude Medical Cardiovascular Group, Inc. | Medical graft connector and methods of making and installing same |
US6350277B1 (en) | 1999-01-15 | 2002-02-26 | Scimed Life Systems, Inc. | Stents with temporary retaining bands |
US6156055A (en) | 1999-03-23 | 2000-12-05 | Nitinol Medical Technologies Inc. | Gripping device for implanting, repositioning or extracting an object within a body vessel |
US6695859B1 (en) | 1999-04-05 | 2004-02-24 | Coalescent Surgical, Inc. | Apparatus and methods for anastomosis |
US6666885B2 (en) | 1999-04-16 | 2003-12-23 | Carbomedics Inc. | Heart valve leaflet |
US6309350B1 (en) | 1999-05-03 | 2001-10-30 | Tricardia, L.L.C. | Pressure/temperature/monitor device for heart implantation |
US6712836B1 (en) | 1999-05-13 | 2004-03-30 | St. Jude Medical Atg, Inc. | Apparatus and methods for closing septal defects and occluding blood flow |
US6790229B1 (en) | 1999-05-25 | 2004-09-14 | Eric Berreklouw | Fixing device, in particular for fixing to vascular wall tissue |
US6699256B1 (en) | 1999-06-04 | 2004-03-02 | St. Jude Medical Atg, Inc. | Medical grafting apparatus and methods |
US6287302B1 (en) | 1999-06-14 | 2001-09-11 | Fidus Medical Technology Corporation | End-firing microwave ablation instrument with horn reflection device |
US7033372B1 (en) | 1999-08-04 | 2006-04-25 | Percardia, Inc. | Corkscrew reinforced left ventricle to coronary artery channel |
WO2001015618A2 (en) | 1999-08-31 | 2001-03-08 | The Cleveland Clinic Foundation | Non-occlusive vascular bypass surgical methods and instruments |
AU5812299A (en) | 1999-09-07 | 2001-04-10 | Microvena Corporation | Retrievable septal defect closure device |
GB9925636D0 (en) | 1999-10-29 | 1999-12-29 | Angiomed Ag | Method of, and device for, installing a stent in a sleeve |
US7758624B2 (en) | 2000-11-13 | 2010-07-20 | C. R. Bard, Inc. | Implant delivery device |
US20070043435A1 (en) | 1999-11-17 | 2007-02-22 | Jacques Seguin | Non-cylindrical prosthetic valve system for transluminal delivery |
US6458153B1 (en) | 1999-12-31 | 2002-10-01 | Abps Venture One, Ltd. | Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof |
DE10000137A1 (de) | 2000-01-04 | 2001-07-12 | Pfm Prod Fuer Die Med Ag | Implantat zum Verschließen von Defektöffnungen im menschlichen oder tierischen Körper |
US6468301B1 (en) | 2000-03-27 | 2002-10-22 | Aga Medical Corporation | Repositionable and recapturable vascular stent/graft |
US6468303B1 (en) | 2000-03-27 | 2002-10-22 | Aga Medical Corporation | Retrievable self expanding shunt |
US7056294B2 (en) | 2000-04-13 | 2006-06-06 | Ev3 Sunnyvale, Inc | Method and apparatus for accessing the left atrial appendage |
US6214029B1 (en) * | 2000-04-26 | 2001-04-10 | Microvena Corporation | Septal defect occluder |
US6334864B1 (en) | 2000-05-17 | 2002-01-01 | Aga Medical Corp. | Alignment member for delivering a non-symmetric device with a predefined orientation |
US6440152B1 (en) | 2000-07-28 | 2002-08-27 | Microvena Corporation | Defect occluder release assembly and method |
US6527746B1 (en) | 2000-08-03 | 2003-03-04 | Ev3, Inc. | Back-loading catheter |
US6572652B2 (en) | 2000-08-29 | 2003-06-03 | Venpro Corporation | Method and devices for decreasing elevated pulmonary venous pressure |
US7691144B2 (en) | 2003-10-01 | 2010-04-06 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
SE517410C2 (sv) | 2000-09-20 | 2002-06-04 | Jan Otto Solem | Anordning och införingsanordning för åstadkommande av ett komplementblodflöde till en kransartär |
US20020082525A1 (en) | 2000-10-18 | 2002-06-27 | Oslund John C. | Rapid exchange delivery catheter |
US6936058B2 (en) | 2000-10-18 | 2005-08-30 | Nmt Medical, Inc. | Over-the-wire interlock attachment/detachment mechanism |
EP1341487B1 (de) | 2000-12-15 | 2005-11-23 | Angiomed GmbH & Co. Medizintechnik KG | Stent mit herzklappe |
CN100342829C (zh) | 2001-02-05 | 2007-10-17 | 维亚科公司 | 改善二尖瓣功能的方法和装置 |
US6802846B2 (en) | 2001-02-12 | 2004-10-12 | Ams Research Corporation | Foreign body retrieval device and method |
US6979343B2 (en) | 2001-02-14 | 2005-12-27 | Ev3 Inc. | Rolled tip recovery catheter |
US6562066B1 (en) | 2001-03-02 | 2003-05-13 | Eric C. Martin | Stent for arterialization of the coronary sinus and retrograde perfusion of the myocardium |
US6958076B2 (en) | 2001-04-16 | 2005-10-25 | Biomedical Research Associates Inc. | Implantable venous valve |
US8091556B2 (en) | 2001-04-20 | 2012-01-10 | V-Wave Ltd. | Methods and apparatus for reducing localized circulatory system pressure |
US6699283B2 (en) | 2001-04-26 | 2004-03-02 | Daniel Clarke Mazzucco | Heart valve with rectangular orifice |
US6837901B2 (en) | 2001-04-27 | 2005-01-04 | Intek Technology L.L.C. | Methods for delivering, repositioning and/or retrieving self-expanding stents |
US20030130713A1 (en) | 2001-05-21 | 2003-07-10 | Stewart Mark T. | Trans-septal catheter with retention mechanism |
US7338514B2 (en) | 2001-06-01 | 2008-03-04 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods and tools, and related methods of use |
KR100393548B1 (ko) | 2001-06-05 | 2003-08-02 | 주식회사 엠아이텍 | 의료용 스텐트 |
JP4201702B2 (ja) | 2001-06-20 | 2008-12-24 | パーク メディカル リミテッド ライアビリティ カンパニー | 吻合装置 |
US8771302B2 (en) | 2001-06-29 | 2014-07-08 | Medtronic, Inc. | Method and apparatus for resecting and replacing an aortic valve |
FR2827153A1 (fr) | 2001-07-12 | 2003-01-17 | Younes Boudjemline | Dispositif pour fermer les defauts septaux |
US7572288B2 (en) | 2001-07-20 | 2009-08-11 | Microvention, Inc. | Aneurysm treatment device and method of use |
WO2003013793A1 (en) | 2001-08-10 | 2003-02-20 | American Tool Companies, Inc. | Increased and variable force and multi-speed clamps |
US20060052821A1 (en) | 2001-09-06 | 2006-03-09 | Ovalis, Inc. | Systems and methods for treating septal defects |
WO2003022344A2 (en) | 2001-09-06 | 2003-03-20 | Nmt Medical, Inc. | Flexible delivery system |
US20070129755A1 (en) | 2005-12-05 | 2007-06-07 | Ovalis, Inc. | Clip-based systems and methods for treating septal defects |
JP2005532832A (ja) | 2001-09-24 | 2005-11-04 | ノヴォスト コーポレイション | 不整脈の治療に電離放射線を用いる方法および装置 |
US6669693B2 (en) | 2001-11-13 | 2003-12-30 | Mayo Foundation For Medical Education And Research | Tissue ablation device and methods of using |
AU2002360695A1 (en) | 2001-12-19 | 2003-07-09 | Nmt Medical, Inc. | Septal occluder and associated methods |
US7318833B2 (en) | 2001-12-19 | 2008-01-15 | Nmt Medical, Inc. | PFO closure device with flexible thrombogenic joint and improved dislodgement resistance |
US7037329B2 (en) | 2002-01-07 | 2006-05-02 | Eric C. Martin | Bifurcated stent for percutaneous arterialization of the coronary sinus and retrograde perfusion of the myocardium |
US6638257B2 (en) | 2002-03-01 | 2003-10-28 | Aga Medical Corporation | Intravascular flow restrictor |
EP1480565B8 (de) | 2002-03-01 | 2009-04-01 | Regents Of The University Of Minnesota | Vaskuläre okklusionsvorrichtung |
US6866679B2 (en) | 2002-03-12 | 2005-03-15 | Ev3 Inc. | Everting stent and stent delivery system |
CA2467702C (en) | 2002-03-15 | 2009-01-13 | Nmt Medical, Inc. | Coupling system useful in placement of implants |
US7976564B2 (en) | 2002-05-06 | 2011-07-12 | St. Jude Medical, Cardiology Division, Inc. | PFO closure devices and related methods of use |
US7485141B2 (en) | 2002-05-10 | 2009-02-03 | Cordis Corporation | Method of placing a tubular membrane on a structural frame |
JP2005528162A (ja) | 2002-06-03 | 2005-09-22 | エヌエムティー メディカル インコーポレイテッド | 心臓内欠損閉塞のための生物学的組織足場を有するデバイス |
US20030181843A1 (en) | 2002-06-11 | 2003-09-25 | Scout Medical Technologies, Llc | Device and method providing arterial blood flow for perfusion of ischemic myocardium |
US7717934B2 (en) | 2002-06-14 | 2010-05-18 | Ev3 Inc. | Rapid exchange catheters usable with embolic protection devices |
US7166120B2 (en) | 2002-07-12 | 2007-01-23 | Ev3 Inc. | Catheter with occluding cuff |
US20040044351A1 (en) | 2002-08-27 | 2004-03-04 | Gary Searle | Mechanical occluding device |
AU2003268220B8 (en) | 2002-08-28 | 2010-01-21 | Hlt, Inc. | Method and device for treating diseased valve |
DE10242444A1 (de) | 2002-09-11 | 2004-04-01 | pfm Produkte für die Medizin AG | Extraktionsvorrichtung |
US7137184B2 (en) | 2002-09-20 | 2006-11-21 | Edwards Lifesciences Corporation | Continuous heart valve support frame and method of manufacture |
US8303511B2 (en) | 2002-09-26 | 2012-11-06 | Pacesetter, Inc. | Implantable pressure transducer system optimized for reduced thrombosis effect |
US20050119735A1 (en) | 2002-10-21 | 2005-06-02 | Spence Paul A. | Tissue fastening systems and methods utilizing magnetic guidance |
US7404824B1 (en) | 2002-11-15 | 2008-07-29 | Advanced Cardiovascular Systems, Inc. | Valve aptation assist device |
US20040102719A1 (en) | 2002-11-22 | 2004-05-27 | Velocimed, L.L.C. | Guide wire control catheters for crossing occlusions and related methods of use |
US7316708B2 (en) | 2002-12-05 | 2008-01-08 | Cardiac Dimensions, Inc. | Medical device delivery system |
US7270662B2 (en) | 2004-01-21 | 2007-09-18 | Naheed Visram | Surgical perforation device with electrocardiogram (ECG) monitoring ability and method of using ECG to position a surgical perforation device |
US7112197B2 (en) | 2003-01-21 | 2006-09-26 | Baylis Medical Company Inc. | Surgical device with pressure monitoring ability |
US7048733B2 (en) | 2003-09-19 | 2006-05-23 | Baylis Medical Company Inc. | Surgical perforation device with curve |
US20040143262A1 (en) | 2003-01-21 | 2004-07-22 | Baylis Medical Company Inc. | Surgical perforation device and method with pressure monitoring and staining abilities |
DE10362223B4 (de) | 2003-01-21 | 2010-02-04 | pfm Produkte für die Medizin AG | Grundwickelform |
US6960224B2 (en) | 2003-01-22 | 2005-11-01 | Cardia, Inc. | Laminated sheets for use in a fully retrievable occlusion device |
US8021359B2 (en) | 2003-02-13 | 2011-09-20 | Coaptus Medical Corporation | Transseptal closure of a patent foramen ovale and other cardiac defects |
US20040162514A1 (en) | 2003-02-14 | 2004-08-19 | Scout Medical Technologies | System and method for controlling differential pressure in a cardio-vascular system |
US20040176788A1 (en) | 2003-03-07 | 2004-09-09 | Nmt Medical, Inc. | Vacuum attachment system |
US7658747B2 (en) | 2003-03-12 | 2010-02-09 | Nmt Medical, Inc. | Medical device for manipulation of a medical implant |
JP4624984B2 (ja) | 2003-03-12 | 2011-02-02 | クック インコーポレイテッド | 逆流を許容する人工弁 |
US7473266B2 (en) | 2003-03-14 | 2009-01-06 | Nmt Medical, Inc. | Collet-based delivery system |
CN1780591A (zh) | 2003-03-27 | 2006-05-31 | 赛热股份有限公司 | 治疗未闭椭圆孔的方法和装置 |
US7967769B2 (en) | 2003-04-08 | 2011-06-28 | Rox Medical Inc. | Implantable arterio-venous shunt devices and methods for their use |
US8372112B2 (en) | 2003-04-11 | 2013-02-12 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods, and related methods of use |
US20040267306A1 (en) | 2003-04-11 | 2004-12-30 | Velocimed, L.L.C. | Closure devices, related delivery methods, and related methods of use |
US7530995B2 (en) | 2003-04-17 | 2009-05-12 | 3F Therapeutics, Inc. | Device for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US7159593B2 (en) | 2003-04-17 | 2007-01-09 | 3F Therapeutics, Inc. | Methods for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US20040215323A1 (en) | 2003-04-24 | 2004-10-28 | Medtronic Ave, Inc. | Membrane eyelet |
US7604660B2 (en) | 2003-05-01 | 2009-10-20 | Merit Medical Systems, Inc. | Bifurcated medical appliance delivery apparatus and method |
US7105024B2 (en) | 2003-05-06 | 2006-09-12 | Aesculap Ii, Inc. | Artificial intervertebral disc |
US6913614B2 (en) | 2003-05-08 | 2005-07-05 | Cardia, Inc. | Delivery system with safety tether |
US20040236308A1 (en) | 2003-05-22 | 2004-11-25 | Atrium Medical Corp. | Kinetic isolation pressurization |
US6921397B2 (en) | 2003-05-27 | 2005-07-26 | Cardia, Inc. | Flexible delivery device |
US7413563B2 (en) | 2003-05-27 | 2008-08-19 | Cardia, Inc. | Flexible medical device |
US8480706B2 (en) | 2003-07-14 | 2013-07-09 | W.L. Gore & Associates, Inc. | Tubular patent foramen ovale (PFO) closure device with catch system |
EP2481356B1 (de) | 2003-07-14 | 2013-09-11 | W.L. Gore & Associates, Inc. | Rohrförmige Verschlussvorrichtung mit Sperrsystem für persistierendes Foramen ovale (PFO) |
US7247269B2 (en) | 2003-07-21 | 2007-07-24 | Biosense Webster, Inc. | Method for making a spiral array ultrasound transducer |
US7860579B2 (en) | 2003-07-25 | 2010-12-28 | Integrated Sensing Systems, Inc. | Delivery system, method, and anchor for medical implant placement |
US7317951B2 (en) | 2003-07-25 | 2008-01-08 | Integrated Sensing Systems, Inc. | Anchor for medical implant placement and method of manufacture |
WO2005018728A2 (en) | 2003-08-19 | 2005-03-03 | Nmt Medical, Inc. | Expandable sheath tubing |
DE10340265A1 (de) | 2003-08-29 | 2005-04-07 | Sievers, Hans-Hinrich, Prof. Dr.med. | Prothese zum Ersatz der Aorten- und/oder Mitralklappe des Herzens |
US20050049692A1 (en) | 2003-09-02 | 2005-03-03 | Numamoto Michael J. | Medical device for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US7144410B2 (en) | 2003-09-18 | 2006-12-05 | Cardia Inc. | ASD closure device with self centering arm network |
US7192435B2 (en) * | 2003-09-18 | 2007-03-20 | Cardia, Inc. | Self centering closure device for septal occlusion |
WO2005027753A1 (en) | 2003-09-19 | 2005-03-31 | St. Jude Medical, Inc. | Apparatus and methods for tissue gathering and securing |
US7658748B2 (en) | 2003-09-23 | 2010-02-09 | Cardia, Inc. | Right retrieval mechanism |
US7309341B2 (en) | 2003-09-30 | 2007-12-18 | Ethicon Endo-Surgery, Inc. | Single lumen anastomosis applier for self-deploying fastener |
US7608086B2 (en) | 2003-09-30 | 2009-10-27 | Ethicon Endo-Surgery, Inc. | Anastomosis wire ring device |
US20050119676A1 (en) | 2003-09-30 | 2005-06-02 | Bumbalough Timothy R. | Applier having automated release of surgical device |
US7419498B2 (en) | 2003-10-21 | 2008-09-02 | Nmt Medical, Inc. | Quick release knot attachment system |
US7347869B2 (en) | 2003-10-31 | 2008-03-25 | Cordis Corporation | Implantable valvular prosthesis |
US8292910B2 (en) | 2003-11-06 | 2012-10-23 | Pressure Products Medical Supplies, Inc. | Transseptal puncture apparatus |
WO2005048883A1 (en) | 2003-11-13 | 2005-06-02 | Fidel Realyvasquez | Methods and apparatus for valve repair |
SE526861C2 (sv) | 2003-11-17 | 2005-11-15 | Syntach Ag | Vävnadslesionsskapande anordning samt en uppsättning av anordningar för behandling av störningar i hjärtrytmregleringssystemet |
WO2005055834A1 (en) | 2003-11-20 | 2005-06-23 | Nmt Medical, Inc. | Device, with electrospun fabric, for a percutaneous transluminal procedure, and methods thereof |
US20050165344A1 (en) | 2003-11-26 | 2005-07-28 | Dobak John D.Iii | Method and apparatus for treating heart failure |
US20050137609A1 (en) | 2003-12-17 | 2005-06-23 | Gerald Guiraudon | Universal cardiac introducer |
US20050137686A1 (en) | 2003-12-23 | 2005-06-23 | Sadra Medical, A Delaware Corporation | Externally expandable heart valve anchor and method |
US8864822B2 (en) | 2003-12-23 | 2014-10-21 | Mitralign, Inc. | Devices and methods for introducing elements into tissue |
CA2554595C (en) | 2004-02-03 | 2016-03-29 | Atria Medical Inc. | Device and method for controlling in-vivo pressure |
EP1737349A1 (de) | 2004-03-03 | 2007-01-03 | NMT Medical, Inc. | Abgabe/rückholsystem für einen septumokkludierer |
US9039724B2 (en) | 2004-03-19 | 2015-05-26 | Aga Medical Corporation | Device for occluding vascular defects |
US8398670B2 (en) | 2004-03-19 | 2013-03-19 | Aga Medical Corporation | Multi-layer braided structures for occluding vascular defects and for occluding fluid flow through portions of the vasculature of the body |
US8777974B2 (en) | 2004-03-19 | 2014-07-15 | Aga Medical Corporation | Multi-layer braided structures for occluding vascular defects |
US8313505B2 (en) | 2004-03-19 | 2012-11-20 | Aga Medical Corporation | Device for occluding vascular defects |
US8747453B2 (en) | 2008-02-18 | 2014-06-10 | Aga Medical Corporation | Stent/stent graft for reinforcement of vascular abnormalities and associated method |
EP1761202A4 (de) | 2004-03-23 | 2012-06-13 | Correx Inc | Vorrichtung und verfahren zum verbinden einer leitung mit einem hohlen organ |
US7799041B2 (en) | 2004-03-23 | 2010-09-21 | Correx, Inc. | Apparatus and method for forming a hole in a hollow organ |
AU2005232562B2 (en) | 2004-04-08 | 2009-05-07 | St. Jude Medical, Cardiology Division, Inc. | Flange occlusion devices and methods |
US20050267524A1 (en) | 2004-04-09 | 2005-12-01 | Nmt Medical, Inc. | Split ends closure device |
US7143625B2 (en) | 2004-04-16 | 2006-12-05 | Boston Scientific Scimed, Inc. | Stent crimper |
US7654997B2 (en) | 2004-04-21 | 2010-02-02 | Acclarent, Inc. | Devices, systems and methods for diagnosing and treating sinusitus and other disorders of the ears, nose and/or throat |
US7803150B2 (en) | 2004-04-21 | 2010-09-28 | Acclarent, Inc. | Devices, systems and methods useable for treating sinusitis |
US20060004323A1 (en) | 2004-04-21 | 2006-01-05 | Exploramed Nc1, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
US7462175B2 (en) | 2004-04-21 | 2008-12-09 | Acclarent, Inc. | Devices, systems and methods for treating disorders of the ear, nose and throat |
CA2563426C (en) | 2004-05-05 | 2013-12-24 | Direct Flow Medical, Inc. | Unstented heart valve with formed in place support structure |
US8308760B2 (en) | 2004-05-06 | 2012-11-13 | W.L. Gore & Associates, Inc. | Delivery systems and methods for PFO closure device with two anchors |
US7704268B2 (en) | 2004-05-07 | 2010-04-27 | Nmt Medical, Inc. | Closure device with hinges |
US20050251063A1 (en) | 2004-05-07 | 2005-11-10 | Raghuveer Basude | Safety device for sampling tissue |
US20050273075A1 (en) | 2004-06-08 | 2005-12-08 | Peter Krulevitch | Method for delivering drugs to the adventitia using device having microprojections |
US20060009832A1 (en) | 2004-07-09 | 2006-01-12 | Conor Medsystems, Inc. | Balloon catheter and method and system for securing a stent to a balloon catheter |
US9138228B2 (en) | 2004-08-11 | 2015-09-22 | Emory University | Vascular conduit device and system for implanting |
US20060041183A1 (en) | 2004-08-20 | 2006-02-23 | Massen Richard J | Electromechanical machine-based artificial muscles, bio-valves and related devices |
CN101035488A (zh) | 2004-09-24 | 2007-09-12 | 因瓦泰克有限公司 | 用于处理分叉的组件 |
WO2006036837A2 (en) | 2004-09-24 | 2006-04-06 | Nmt Medical, Inc. | Occluder device double securement system for delivery/recovery of such occluder device |
CA2582160A1 (en) | 2004-10-08 | 2006-04-20 | Sinus Rhythm Technologies, Inc. | Two-stage scar generation for treating atrial fibrillation |
WO2006042280A2 (en) | 2004-10-12 | 2006-04-20 | Alexander Shaknovich | System and method for assisted partitioning of body conduits |
US20060085060A1 (en) | 2004-10-15 | 2006-04-20 | Campbell Louis A | Methods and apparatus for coupling an allograft tissue valve and graft |
US7722629B2 (en) | 2004-10-29 | 2010-05-25 | Jeffrey W. Chambers, M.D. | System and method for catheter-based septal defect repair |
US20060111704A1 (en) | 2004-11-22 | 2006-05-25 | Rox Medical, Inc. | Devices, systems, and methods for energy assisted arterio-venous fistula creation |
US7905901B2 (en) | 2004-11-29 | 2011-03-15 | Cardia, Inc. | Self-centering occlusion device |
US7582104B2 (en) | 2004-12-08 | 2009-09-01 | Cardia, Inc. | Daisy design for occlusion device |
US8162905B2 (en) | 2004-12-17 | 2012-04-24 | W. L. Gore & Associates, Inc. | Delivery system |
US9545300B2 (en) | 2004-12-22 | 2017-01-17 | W. L. Gore & Associates, Inc. | Filament-wound implantable devices |
US20060241677A1 (en) | 2005-01-03 | 2006-10-26 | Eric Johnson | Methods for maintaining a filtering device within a lumen |
DE102005003632A1 (de) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Katheter für die transvaskuläre Implantation von Herzklappenprothesen |
US8372113B2 (en) | 2005-03-24 | 2013-02-12 | W.L. Gore & Associates, Inc. | Curved arm intracardiac occluder |
US20060276882A1 (en) | 2005-04-11 | 2006-12-07 | Cook Incorporated | Medical device including remodelable material attached to frame |
SE531468C2 (sv) | 2005-04-21 | 2009-04-14 | Edwards Lifesciences Ag | En anordning för styrning av blodflöde |
US7758589B2 (en) | 2005-05-03 | 2010-07-20 | Ethicon Endo-Surgery, Inc. | Surgical instrument for extracting an anastomotic ring device |
US20060253184A1 (en) | 2005-05-04 | 2006-11-09 | Kurt Amplatz | System for the controlled delivery of stents and grafts |
US20070118207A1 (en) | 2005-05-04 | 2007-05-24 | Aga Medical Corporation | System for controlled delivery of stents and grafts |
DE102005022423B3 (de) | 2005-05-14 | 2007-01-18 | Osypka, Peter, Dr.-Ing. | Vorrichtung zum Einbringen eines Gegenstandes im Inneren eines Blutgefässes oder des Herzens |
US20070005127A1 (en) | 2005-06-17 | 2007-01-04 | Peter Boekstegers | Hinged tissue implant and related methods and devices for delivering such an implant |
US20070021739A1 (en) | 2005-07-24 | 2007-01-25 | Lascor Gmbh | Inter-atrial Transseptal Laser Puncture (TLP) Procedure |
WO2007014313A2 (en) | 2005-07-26 | 2007-02-01 | Precision Thoracic Corporation | Minimally invasive methods and apparatus |
EP1919398B1 (de) | 2005-07-29 | 2014-03-05 | Cook Medical Technologies LLC | Elliptische implantierbare vorrichtung |
US20070038295A1 (en) | 2005-08-12 | 2007-02-15 | Cook Incorporated | Artificial valve prosthesis having a ring frame |
US20070043431A1 (en) | 2005-08-19 | 2007-02-22 | Cook Incorporated | Prosthetic valve |
WO2007025028A1 (en) | 2005-08-25 | 2007-03-01 | The Cleveland Clinic Foundation | Percutaneous atrioventricular valve and method of use |
US20070088388A1 (en) | 2005-09-19 | 2007-04-19 | Opolski Steven W | Delivery device for implant with dual attachment sites |
US20070123934A1 (en) | 2005-09-26 | 2007-05-31 | Whisenant Brian K | Delivery system for patent foramen ovale closure device |
ATE474503T1 (de) | 2005-11-11 | 2010-08-15 | Occlutech Gmbh | Occlusionsinstrument zum verschliessen eines herzohres |
US7955354B2 (en) | 2005-11-14 | 2011-06-07 | Occlutech Gmbh | Occlusion device and surgical instrument and method for its implantation/explantation |
CA2634754A1 (en) | 2005-12-29 | 2007-07-12 | Nmt Medical, Inc. | Syringe activated-valve for flushing a catheter and methods thereof |
US8778008B2 (en) | 2006-01-13 | 2014-07-15 | Aga Medical Corporation | Intravascular deliverable stent for reinforcement of vascular abnormalities |
US8900287B2 (en) | 2006-01-13 | 2014-12-02 | Aga Medical Corporation | Intravascular deliverable stent for reinforcement of abdominal aortic aneurysm |
WO2007083288A2 (en) | 2006-01-23 | 2007-07-26 | Atria Medical Inc. | Heart anchor device |
US20080161901A1 (en) | 2006-01-25 | 2008-07-03 | Heuser Richard R | Catheter system with stent apparatus for connecting adjacent blood vessels |
US7625392B2 (en) | 2006-02-03 | 2009-12-01 | James Coleman | Wound closure devices and methods |
EP2583640B1 (de) | 2006-02-16 | 2022-06-22 | Venus MedTech (HangZhou), Inc. | Minimalinvasiver Herzklappenersatz |
US7648527B2 (en) | 2006-03-01 | 2010-01-19 | Cook Incorporated | Methods of reducing retrograde flow |
US20070209957A1 (en) | 2006-03-09 | 2007-09-13 | Sdgi Holdings, Inc. | Packaging system for medical devices |
US20070225759A1 (en) | 2006-03-22 | 2007-09-27 | Daniel Thommen | Method for delivering a medical device to the heart of a patient |
CN101049268B (zh) | 2006-04-03 | 2011-09-14 | 孟坚 | 医疗用闭塞器械 |
DE102006036649A1 (de) | 2006-04-27 | 2007-10-31 | Biophan Europe Gmbh | Okkluder |
EP1849440A1 (de) | 2006-04-28 | 2007-10-31 | Younes Boudjemline | Vaskuläre Stents mit verschiedenen Durchmessern |
EP2023860A2 (de) | 2006-04-29 | 2009-02-18 | Arbor Surgical Technologies, Inc. | Mehrteilige herzklappenprothesenanordnungen sowie vorrichtung und verfahren zu ihrer einsetzung |
US20070265658A1 (en) | 2006-05-12 | 2007-11-15 | Aga Medical Corporation | Anchoring and tethering system |
US20070270741A1 (en) | 2006-05-17 | 2007-11-22 | Hassett James A | Transseptal needle assembly and methods |
DE602006021485D1 (de) | 2006-05-17 | 2011-06-01 | Syntach Ag | Kontrollierbare vorrichtung und kit zur behandlung von störungen des herzrhythmus-reguliersystems |
US8092517B2 (en) | 2006-05-25 | 2012-01-10 | Deep Vein Medical, Inc. | Device for regulating blood flow |
US7938826B2 (en) | 2006-05-30 | 2011-05-10 | Coherex Medical, Inc. | Methods, systems, and devices for closing a patent foramen ovale using mechanical structures |
US8402974B2 (en) | 2006-05-30 | 2013-03-26 | Coherex Medical, Inc. | Methods, systems, and devices for sensing, measuring, and controlling closure of a patent foramen ovale |
US7815676B2 (en) | 2006-07-07 | 2010-10-19 | The Cleveland Clinic Foundation | Apparatus and method for assisting in the removal of a cardiac valve |
US8010186B1 (en) | 2006-07-19 | 2011-08-30 | Pacesetter, Inc. | System and related methods for identifying a fibrillation driver |
US20080039743A1 (en) | 2006-08-09 | 2008-02-14 | Coherex Medical, Inc. | Methods for determining characteristics of an internal tissue opening |
US20080058940A1 (en) | 2006-08-22 | 2008-03-06 | Shing Sheng Wu | Artificial intervertebral disc |
EP2059198B1 (de) | 2006-09-06 | 2014-01-15 | Cook Medical Technologies LLC | Stents mit steckverbindern und biologisch abbaubaren stabilisierungselementen |
US8876895B2 (en) | 2006-09-19 | 2014-11-04 | Medtronic Ventor Technologies Ltd. | Valve fixation member having engagement arms |
WO2008042229A2 (en) | 2006-09-28 | 2008-04-10 | Nmt Medical, Inc. | Implant-catheter attachment mechanism using snare and method of use |
WO2008070262A2 (en) | 2006-10-06 | 2008-06-12 | The Cleveland Clinic Foundation | Apparatus and method for targeting a body tissue |
US20080103508A1 (en) | 2006-11-01 | 2008-05-01 | Ali Serdar Karakurum | Apparatus and method for removal of foreign matter from a patient |
US20080109069A1 (en) | 2006-11-07 | 2008-05-08 | Coleman James E | Blood perfusion graft |
US10413284B2 (en) | 2006-11-07 | 2019-09-17 | Corvia Medical, Inc. | Atrial pressure regulation with control, sensing, monitoring and therapy delivery |
US9232997B2 (en) | 2006-11-07 | 2016-01-12 | Corvia Medical, Inc. | Devices and methods for retrievable intra-atrial implants |
US8745845B2 (en) | 2006-11-07 | 2014-06-10 | Dc Devices, Inc. | Methods for mounting a prosthesis onto a delivery device |
US20110257723A1 (en) | 2006-11-07 | 2011-10-20 | Dc Devices, Inc. | Devices and methods for coronary sinus pressure relief |
WO2008055301A1 (en) | 2006-11-07 | 2008-05-15 | Univ Sydney | Devices and methods for the treatment of heart failure |
US8460372B2 (en) | 2006-11-07 | 2013-06-11 | Dc Devices, Inc. | Prosthesis for reducing intra-cardiac pressure having an embolic filter |
SE530568C2 (sv) | 2006-11-13 | 2008-07-08 | Medtentia Ab | Anordning och metod för förbättring av funktionen hos en hjärtklaff |
US7350995B1 (en) | 2006-12-19 | 2008-04-01 | Rhodes Julia M | Marker eraser system |
US8337518B2 (en) | 2006-12-20 | 2012-12-25 | Onset Medical Corporation | Expandable trans-septal sheath |
US8236045B2 (en) | 2006-12-22 | 2012-08-07 | Edwards Lifesciences Corporation | Implantable prosthetic valve assembly and method of making the same |
US7959668B2 (en) | 2007-01-16 | 2011-06-14 | Boston Scientific Scimed, Inc. | Bifurcated stent |
WO2008089365A2 (en) | 2007-01-19 | 2008-07-24 | The Cleveland Clinic Foundation | Method for implanting a cardiovascular valve |
US7678144B2 (en) | 2007-01-29 | 2010-03-16 | Cook Incorporated | Prosthetic valve with slanted leaflet design |
WO2008094706A2 (en) | 2007-02-01 | 2008-08-07 | Cook Incorporated | Closure device and method of closing a bodily opening |
DE102007005900A1 (de) | 2007-02-01 | 2008-08-07 | Endosmart Gesellschaft für innovative Medizintechnik mbH | Instrument zum operativen Entfernen einer defekten Herzklappe |
US20080221582A1 (en) | 2007-03-05 | 2008-09-11 | Pulmonx | Pulmonary stent removal device |
US8092523B2 (en) | 2007-03-12 | 2012-01-10 | St. Jude Medical, Inc. | Prosthetic heart valves with flexible leaflets |
US9005242B2 (en) | 2007-04-05 | 2015-04-14 | W.L. Gore & Associates, Inc. | Septal closure device with centering mechanism |
US8187284B2 (en) | 2007-04-23 | 2012-05-29 | Boston Scientific Scimed, Inc. | Intraluminary stent relocating apparatus |
US7846123B2 (en) | 2007-04-24 | 2010-12-07 | Emory University | Conduit device and system for implanting a conduit device in a tissue wall |
US9017362B2 (en) | 2007-06-13 | 2015-04-28 | Cook Medical Technologies Llc | Occluding device |
US8048147B2 (en) | 2007-06-27 | 2011-11-01 | Aga Medical Corporation | Branched stent/graft and method of fabrication |
US20090054984A1 (en) | 2007-08-20 | 2009-02-26 | Histogenics Corporation | Method For Use Of A Double-Structured Tissue Implant For Treatment Of Tissue Defects |
US8034061B2 (en) | 2007-07-12 | 2011-10-11 | Aga Medical Corporation | Percutaneous catheter directed intravascular occlusion devices |
US8006535B2 (en) | 2007-07-12 | 2011-08-30 | Sorin Biomedica Cardio S.R.L. | Expandable prosthetic valve crimping device |
US20090030495A1 (en) | 2007-07-25 | 2009-01-29 | Abbott Laboratories Vascular Enterprises Limited | System for controlled prosthesis deployment |
US8361138B2 (en) | 2007-07-25 | 2013-01-29 | Aga Medical Corporation | Braided occlusion device having repeating expanded volume segments separated by articulation segments |
US20090112251A1 (en) | 2007-07-25 | 2009-04-30 | Aga Medical Corporation | Braided occlusion device having repeating expanded volume segments separated by articulation segments |
US7905918B2 (en) | 2007-08-23 | 2011-03-15 | William Wayne Cimino | Elastic metallic replacement ligament |
DE102007043830A1 (de) | 2007-09-13 | 2009-04-02 | Lozonschi, Lucian, Madison | Herzklappenstent |
US20090292310A1 (en) | 2007-09-13 | 2009-11-26 | Dara Chin | Medical device for occluding a heart defect and a method of manufacturing the same |
US8366741B2 (en) | 2007-09-13 | 2013-02-05 | Cardia, Inc. | Occlusion device with centering arm |
US20090082803A1 (en) | 2007-09-26 | 2009-03-26 | Aga Medical Corporation | Braided vascular devices having no end clamps |
US9414842B2 (en) | 2007-10-12 | 2016-08-16 | St. Jude Medical, Cardiology Division, Inc. | Multi-component vascular device |
US8343029B2 (en) | 2007-10-24 | 2013-01-01 | Circulite, Inc. | Transseptal cannula, tip, delivery system, and method |
EP2052688B1 (de) | 2007-10-25 | 2012-06-06 | pfm medical ag | Schlingenmechanismus zum chirurgischen Entnehmen |
US20090171386A1 (en) | 2007-12-28 | 2009-07-02 | Aga Medical Corporation | Percutaneous catheter directed intravascular occlusion devices |
US9743918B2 (en) | 2008-01-18 | 2017-08-29 | St. Jude Medical, Cardiology Division, Inc. | Percutaneous catheter directed intravascular occlusion device |
US20090209999A1 (en) | 2008-02-14 | 2009-08-20 | Michael Afremov | Device and Method for Closure of Atrial Septal Defects |
US8163004B2 (en) | 2008-02-18 | 2012-04-24 | Aga Medical Corporation | Stent graft for reinforcement of vascular abnormalities and associated method |
US9259225B2 (en) | 2008-02-19 | 2016-02-16 | St. Jude Medical, Cardiology Division, Inc. | Medical devices for treating a target site and associated method |
US20130165967A1 (en) | 2008-03-07 | 2013-06-27 | W.L. Gore & Associates, Inc. | Heart occlusion devices |
EP2268214A1 (de) | 2008-03-11 | 2011-01-05 | UMC Utrecht Holding B.V. | Vorrichtung und verfahren zur transseptalen punktion |
WO2009121001A1 (en) | 2008-03-28 | 2009-10-01 | Coherex Medical, Inc. | Delivery systems for a medical device and related methods |
WO2009129481A1 (en) | 2008-04-18 | 2009-10-22 | Cook Incorporated | Branched vessel prosthesis |
WO2009137755A2 (en) | 2008-05-09 | 2009-11-12 | University Of Pittsburgh- Commonwealth System Of Higher Education | Biologic matrix for cardiac repair |
US8454632B2 (en) | 2008-05-12 | 2013-06-04 | Xlumena, Inc. | Tissue anchor for securing tissue layers |
RU2373900C1 (ru) | 2008-07-23 | 2009-11-27 | Закрытое Акционерное Общество Научно-Производственное Предприятие "Мединж" | Протез клапана сердца |
US9232992B2 (en) | 2008-07-24 | 2016-01-12 | Aga Medical Corporation | Multi-layered medical device for treating a target site and associated method |
US9351715B2 (en) | 2008-07-24 | 2016-05-31 | St. Jude Medical, Cardiology Division, Inc. | Multi-layered medical device for treating a target site and associated method |
US20100022940A1 (en) | 2008-07-25 | 2010-01-28 | Medtronic Vascular, Inc. | Percutaneously Introduceable Shunt Devices and Methods |
US20100030321A1 (en) | 2008-07-29 | 2010-02-04 | Aga Medical Corporation | Medical device including corrugated braid and associated method |
US20100049307A1 (en) | 2008-08-25 | 2010-02-25 | Aga Medical Corporation | Stent graft having extended landing area and method for using the same |
US8944411B2 (en) | 2008-08-29 | 2015-02-03 | Corning Cable Systems Llc | Pulling grip assembly for a fiber optic assembly |
US20100063578A1 (en) | 2008-09-05 | 2010-03-11 | Aga Medical Corporation | Bifurcated medical device for treating a target site and associated method |
EP2326259B1 (de) | 2008-09-05 | 2021-06-23 | Pulsar Vascular, Inc. | Systeme zur stützung oder verschliessung einer körperöffnung oder -kavität |
US9427304B2 (en) | 2008-10-27 | 2016-08-30 | St. Jude Medical, Cardiology Division, Inc. | Multi-layer device with gap for treating a target site and associated method |
US8940015B2 (en) | 2008-11-11 | 2015-01-27 | Aga Medical Corporation | Asymmetrical medical devices for treating a target site and associated method |
US8690911B2 (en) | 2009-01-08 | 2014-04-08 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
BRPI1007767A2 (pt) | 2009-02-09 | 2017-06-27 | St Jude Medical Cardiology Div Inc | dispositivo de colocação, e, aparelho de afixação reversível |
US10702275B2 (en) | 2009-02-18 | 2020-07-07 | St. Jude Medical Cardiology Division, Inc. | Medical device with stiffener wire for occluding vascular defects |
WO2010111666A1 (en) | 2009-03-26 | 2010-09-30 | Taheri Laduca Llc | Vascular implants and methods |
US20100249491A1 (en) | 2009-03-27 | 2010-09-30 | Circulite, Inc. | Two-piece transseptal cannula, delivery system, and method of delivery |
US8460168B2 (en) | 2009-03-27 | 2013-06-11 | Circulite, Inc. | Transseptal cannula device, coaxial balloon delivery device, and methods of using the same |
EP2421468B1 (de) | 2009-04-20 | 2016-12-07 | Rox Medical, Inc. | Vorrichtung zur erstellung einer künstlichen venen-arterien-fistel |
US8512397B2 (en) | 2009-04-27 | 2013-08-20 | Sorin Group Italia S.R.L. | Prosthetic vascular conduit |
EP2427143B1 (de) | 2009-05-04 | 2017-08-02 | V-Wave Ltd. | Vorrichtung zur druckregelung in einer herzkammer |
US9034034B2 (en) | 2010-12-22 | 2015-05-19 | V-Wave Ltd. | Devices for reducing left atrial pressure, and methods of making and using same |
US8075611B2 (en) | 2009-06-02 | 2011-12-13 | Medtronic, Inc. | Stented prosthetic heart valves |
CN101579267A (zh) | 2009-06-12 | 2009-11-18 | 陈良万 | 外科术中应用的分支人造血管支架 |
WO2010148246A2 (en) | 2009-06-17 | 2010-12-23 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
US8366088B2 (en) | 2009-07-10 | 2013-02-05 | Ge-Hitachi Nuclear Energy Americas Llc | Brachytherapy and radiography target holding device |
US9757107B2 (en) | 2009-09-04 | 2017-09-12 | Corvia Medical, Inc. | Methods and devices for intra-atrial shunts having adjustable sizes |
US8696693B2 (en) | 2009-12-05 | 2014-04-15 | Integrated Sensing Systems, Inc. | Delivery system, method, and anchor for medical implant placement |
AU2011210741B2 (en) | 2010-01-29 | 2013-08-15 | Corvia Medical, Inc. | Devices and methods for reducing venous pressure |
US20110270239A1 (en) | 2010-04-29 | 2011-11-03 | Werneth Randell L | Transseptal crossing device |
US8579964B2 (en) | 2010-05-05 | 2013-11-12 | Neovasc Inc. | Transcatheter mitral valve prosthesis |
US9510973B2 (en) | 2010-06-23 | 2016-12-06 | Ivantis, Inc. | Ocular implants deployed in schlemm's canal of the eye |
US9132009B2 (en) * | 2010-07-21 | 2015-09-15 | Mitraltech Ltd. | Guide wires with commissural anchors to advance a prosthetic valve |
US8597225B2 (en) * | 2010-07-26 | 2013-12-03 | The Cleveland Clinic Foundation | Method for increasing blood flow in or about a cardiac or other vascular or prosthetic structure to prevent thrombosis |
US9198756B2 (en) | 2010-11-18 | 2015-12-01 | Pavilion Medical Innovations, Llc | Tissue restraining devices and methods of use |
EP2673038B1 (de) | 2011-02-10 | 2017-07-19 | Corvia Medical, Inc. | Vorrichtung zur erzeugung und aufrechterhaltung einer öffnung für intra-atriale druckentlastung |
EP2707077B1 (de) | 2011-05-11 | 2017-10-04 | Microvention, Inc. | Vorrichtung zum verschliessen eines lumens |
US20120289971A1 (en) | 2011-05-11 | 2012-11-15 | Merit Medical Systems, Inc. | Multiple lumen retrieval device and method of using |
US9629715B2 (en) | 2011-07-28 | 2017-04-25 | V-Wave Ltd. | Devices for reducing left atrial pressure having biodegradable constriction, and methods of making and using same |
US8979832B2 (en) | 2011-08-10 | 2015-03-17 | Boston Scientific Scimed, Inc. | Cutting device and related methods of use |
US8951223B2 (en) | 2011-12-22 | 2015-02-10 | Dc Devices, Inc. | Methods and devices for intra-atrial shunts having adjustable sizes |
US9005155B2 (en) | 2012-02-03 | 2015-04-14 | Dc Devices, Inc. | Devices and methods for treating heart failure |
US10588611B2 (en) | 2012-04-19 | 2020-03-17 | Corvia Medical Inc. | Implant retention attachment and method of use |
US9649480B2 (en) | 2012-07-06 | 2017-05-16 | Corvia Medical, Inc. | Devices and methods of treating or ameliorating diastolic heart failure through pulmonary valve intervention |
US9445797B2 (en) | 2012-09-13 | 2016-09-20 | Medtronic, Inc. | Percutaneous atrial and ventricular septal defect closure device |
US20140172074A1 (en) | 2012-12-13 | 2014-06-19 | 480 Biomedical, Inc. | Stent with reinforced joints |
US9775636B2 (en) | 2013-03-12 | 2017-10-03 | Corvia Medical, Inc. | Devices, systems, and methods for treating heart failure |
US20140277054A1 (en) | 2013-03-15 | 2014-09-18 | Dc Devices, Inc. | Devices, systems, and methods for percutaneous trans-septal puncture |
US20150119796A1 (en) | 2013-10-26 | 2015-04-30 | Dc Devices, Inc. | Anti-Lockup Thread Attachment Mechanism and Method of Use Thereof |
US11439396B2 (en) | 2014-05-02 | 2022-09-13 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US11712230B2 (en) | 2014-05-02 | 2023-08-01 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
TR201815290T4 (tr) | 2014-09-09 | 2018-11-21 | Occlutech Holding Ag | Kalpte akış düzenleme cihazı. |
US10932786B2 (en) | 2014-11-04 | 2021-03-02 | Corvia Medical, Inc. | Devices and methods for treating patent ductus arteriosus |
US11135410B2 (en) | 2017-02-26 | 2021-10-05 | Corvia Medical, Inc. | Devices and methods for treating heart failure |
-
2015
- 2015-07-23 EP EP15824456.6A patent/EP3171786B1/de active Active
- 2015-07-23 WO PCT/US2015/041777 patent/WO2016014821A1/en active Application Filing
- 2015-07-23 CA CA2955389A patent/CA2955389C/en active Active
- 2015-07-23 US US14/807,544 patent/US10632292B2/en active Active
- 2015-07-23 JP JP2017503596A patent/JP6799526B2/ja active Active
Non-Patent Citations (1)
Title |
---|
None * |
Also Published As
Publication number | Publication date |
---|---|
CA2955389C (en) | 2023-04-04 |
CA2955389A1 (en) | 2016-01-28 |
EP3171786A4 (de) | 2017-07-05 |
US10632292B2 (en) | 2020-04-28 |
US20160022970A1 (en) | 2016-01-28 |
JP6799526B2 (ja) | 2020-12-16 |
EP3171786A1 (de) | 2017-05-31 |
WO2016014821A8 (en) | 2016-03-24 |
JP2017521185A (ja) | 2017-08-03 |
WO2016014821A1 (en) | 2016-01-28 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
EP3171786B1 (de) | Vorrichtungen zur behandlung von herzinsuffizienz | |
US11135410B2 (en) | Devices and methods for treating heart failure | |
US10675450B2 (en) | Devices and methods for treating heart failure | |
US11786256B2 (en) | Devices and methods for excluding the left atrial appendage | |
US8597225B2 (en) | Method for increasing blood flow in or about a cardiac or other vascular or prosthetic structure to prevent thrombosis | |
US9757107B2 (en) | Methods and devices for intra-atrial shunts having adjustable sizes | |
CN111225621B (zh) | 医疗设备及用于该医疗设备的锚定件 | |
KR102044599B1 (ko) | 공간 충진 장치 | |
JP6240604B2 (ja) | 拡張可能な閉塞デバイス及び方法 | |
US6652555B1 (en) | Barrier device for covering the ostium of left atrial appendage | |
US20150005811A1 (en) | Expandable occlusion devices and methods of use | |
US20140303719A1 (en) | Percutaneously implantable artificial heart valve system and associated methods and devices | |
US20190328374A1 (en) | Trans-septal closure device | |
CA3126178A1 (en) | Vascular implant with anchor member | |
US20220031456A1 (en) | Apparatuses and methods for at least partially supporting a valve leaflet of a regurgitant heart valve | |
AU2022332977A1 (en) | Anchors for implantable medical devices | |
WO2023099516A1 (en) | Medical occlusion device and system comprising the medical occlusion device and a catheter | |
EP4196050A1 (de) | Vorrichtungen und verfahren zur mindestens teilweisen unterstützung eines klappensegels einer herzklappenregurgitation |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE INTERNATIONAL PUBLICATION HAS BEEN MADE |
|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE |
|
17P | Request for examination filed |
Effective date: 20170125 |
|
AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
AX | Request for extension of the european patent |
Extension state: BA ME |
|
A4 | Supplementary search report drawn up and despatched |
Effective date: 20170607 |
|
RIC1 | Information provided on ipc code assigned before grant |
Ipc: A61B 17/00 20060101AFI20170531BHEP |
|
DAV | Request for validation of the european patent (deleted) | ||
DAX | Request for extension of the european patent (deleted) | ||
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: EXAMINATION IS IN PROGRESS |
|
17Q | First examination report despatched |
Effective date: 20180312 |
|
GRAP | Despatch of communication of intention to grant a patent |
Free format text: ORIGINAL CODE: EPIDOSNIGR1 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: GRANT OF PATENT IS INTENDED |
|
INTG | Intention to grant announced |
Effective date: 20191127 |
|
GRAS | Grant fee paid |
Free format text: ORIGINAL CODE: EPIDOSNIGR3 |
|
GRAA | (expected) grant |
Free format text: ORIGINAL CODE: 0009210 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE PATENT HAS BEEN GRANTED |
|
AK | Designated contracting states |
Kind code of ref document: B1 Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
REG | Reference to a national code |
Ref country code: GB Ref legal event code: FG4D |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: EP |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R096 Ref document number: 602015052841 Country of ref document: DE |
|
REG | Reference to a national code |
Ref country code: AT Ref legal event code: REF Ref document number: 1269177 Country of ref document: AT Kind code of ref document: T Effective date: 20200615 |
|
REG | Reference to a national code |
Ref country code: LT Ref legal event code: MG4D |
|
REG | Reference to a national code |
Ref country code: NL Ref legal event code: MP Effective date: 20200513 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: IS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200913 Ref country code: PT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200914 Ref country code: FI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: GR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200814 Ref country code: NO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200813 Ref country code: SE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: LT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: BG Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200813 Ref country code: HR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: LV Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: RS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
REG | Reference to a national code |
Ref country code: AT Ref legal event code: MK05 Ref document number: 1269177 Country of ref document: AT Kind code of ref document: T Effective date: 20200513 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: AL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: NL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: AT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: EE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: DK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: CZ Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: IT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: ES Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: SM Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: RO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R097 Ref document number: 602015052841 Country of ref document: DE |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: PL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: SK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: MC Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: PL |
|
PLBE | No opposition filed within time limit |
Free format text: ORIGINAL CODE: 0009261 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT |
|
26N | No opposition filed |
Effective date: 20210216 |
|
REG | Reference to a national code |
Ref country code: BE Ref legal event code: MM Effective date: 20200731 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: CH Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20200731 Ref country code: LU Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20200723 Ref country code: LI Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20200731 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: BE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20200731 Ref country code: SI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: TR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: MT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 Ref country code: CY Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
REG | Reference to a national code |
Ref country code: FR Ref legal event code: PLFP Year of fee payment: 8 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: MK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20200513 |
|
P01 | Opt-out of the competence of the unified patent court (upc) registered |
Effective date: 20230526 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: IE Payment date: 20230606 Year of fee payment: 9 Ref country code: FR Payment date: 20230620 Year of fee payment: 9 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: GB Payment date: 20230601 Year of fee payment: 9 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: DE Payment date: 20230531 Year of fee payment: 9 |